We are excited to share important new findings from within the WISDOM Study that could reshape the way we think about genetic testing for breast cancer risk. The full text article was published online here December 12, 2025 in JAMA Intern Med.
Analyses of WISDOM participant data from 2016-2023 showed that many women who do not qualify for genetic testing today may still carry important genetic changes linked to breast cancer. This research was led by one of WISDOM’s own investigators, Lisa Madlensky, PhD, a professor of medicine at UC San Diego School of Medicine and director of the Family Center Genetics Program at Moores Cancer Center at UC San Diego Health. Dr. Madlensky has long been a national leader in clinical genetics, and her work continues to expand our understanding of who stands to benefit from personalized breast cancer screening.
What We Found
Under today’s clinical guidelines, most women are only offered genetic testing if they have a strong family history of breast cancer or belong to certain ancestries known to have higher mutation rates. But our new findings suggest that this approach may leave many women unaware of important genetic risks.
In WISDOM, nearly 1 in 38 women carried a pathogenic mutation -a change in a gene that increases breast cancer risk. Importantly, we found that 30% of these women did not have any family history of breast, ovarian, or male breast cancer in their families. Given this fact, they would not normally be offered testing under current clinical guidelines, yet their results could have a real impact on their health decisions including screening and prevention.
Why This Matters
This discovery supports a key idea behind the WISDOM Study: every woman’s breast cancer risk is unique. Genetics, lifestyle, breast density, environment, and other factors all play a role. If many women with no obvious genetic risk factors (like family history of breast cancer) still carry important genetic information, then expanding access to testing may help identify women who can benefit from early, tailored interventions.
Dr. Madlensky’s leadership on this research underscores the value of including genetics into modern breast cancer screening and the importance of questioning the long-standing assumptions about risk.
How This Fits Into the WISDOM Study
The WISDOM Study is designed to test whether personalized screening—based on each woman’s individual risk—is as safe, more effective, and potentially less burdensome than the one-size-fits-all annual mammogram approach.
These new results highlight why a personalized approach matters. When we look at risk from multiple angles, including genetics, we may be able to better identify who needs more—or less—screening over time.
Our Partners in This Work
We’re also grateful for our collaboration with UC San Diego Health, home to Dr. Madlensky and the region’s only National Cancer Institute-designated Comprehensive Cancer Center. Their team provides state-of-the-art breast cancer care, including genetic testing, advanced imaging, surgery options, and access to clinical trials.
Moving Forward
These findings add powerful evidence to a growing body of work showing that risk-based screening has the potential to improve outcomes for many women. We’re proud to see one of our own investigators leading this conversation at the national level, and we’re grateful to every WISDOM participant whose contributions make discoveries like this possible.
