A Milestone Moment: WISDOM 1.0 Results Point to a New Future for Breast Cancer Screening
This year marks a major milestone for the WISDOM Study—and one made possible by the incredible commitment of our community. The long-awaited results from WISDOM 1.0 were published online December 12, 2025, in the Journal of the American Medical Association and presented at the San Antonio Breast Cancer Symposium, the world’s largest conference dedicated solely to breast cancer research. Together, these achievements signal an exciting step forward in how breast cancer screening and prevention may be approached in the future.
WISDOM launched in 2016 with a bold goal: to determine whether screening tailored to a woman’s individual risk could be as safe—and potentially more effective—than the one-size-fits-all approach based mostly on age. The results are in, and they are encouraging.
What We Learned
WISDOM 1.0 enrolled more than 46,000 women between 2016 and 2023. Over 28,000 participants agreed to randomization, with half assigned to annual mammography and half to a personalized, risk-based screening schedule. The central question was straightforward: could tailoring screening intensity to personal risk be as safe as annual screening?
The answer was yes. Matching screening to individual risk did not increase the rate of advanced cancers. In fact, nearly 90% of participants chose risk-based screening when given the option, signaling a strong preference for an approach grounded in personal health information rather than a calendar date.
How Personalized Screening Worked
Participants in the personalized arm completed a detailed questionnaire using the well-validated Breast Cancer Surveillance Consortium (BCSC) risk calculator. Risk assessment also incorporated genetic testing through Color Health’s Hereditary Cancer Panel, polygenic risk scores, breast density, and other biological and lifestyle factors.
Based on this information, women were grouped into four risk categories and matched with screening recommendations aligned to their needs:
- 26% were low risk and advised to delay screening until age 50, or earlier if their risk reached that of an average 50-year-old
- 62% were average risk and recommended screening every two years
- 8% were elevated risk and recommended annual screening
- 2% were high risk and recommended screening twice per year, alternating mammography and MRI
Among women in the highest-risk group, no stage 2B or higher cancers were detected—an especially promising finding that highlights the potential of targeted, intensive screening for those who need it most.
Why WISDOM Is Different
WISDOM is about more than screening intervals—it’s about empowering women with knowledge and options. Participants at elevated or high risk received personalized risk-reduction recommendations, including access to educational tools, consultations with breast health specialists, and guidance on lifestyle changes or medications.
The study also revealed how much risk can be missed under current guidelines. Thirty percent of women who tested positive for high-risk genetic variants had no reported family history of breast cancer and would not have been offered genetic testing otherwise. By looking beyond BRCA1 and BRCA2 and incorporating polygenic risk scores, WISDOM was able to refine risk estimates and reclassify 12–14% of participants into more accurate risk categories.
A Safe, Preferred, and Forward-Looking Approach
Importantly, personalized screening did not increase late-stage cancer diagnoses. The rate of stage 2B or higher cancers—the study’s primary safety outcome—was noninferior in the risk-based group compared with annual screening. While biopsy rates overall were similar between groups, diagnostic procedures were concentrated among women at higher risk, aligning care more closely with need.
Looking Ahead With Gratitude
WISDOM continues to evolve. WISDOM 2.0 began enrolling participants as young as age 30 with the goal of identifying women at higher risk for aggressive breast cancers earlier in life. By combining individualized screening with prevention strategies, we aim to support long-term health and help redefine how breast cancer is detected and prevented.
As we reflect on these results, we are deeply grateful to the tens of thousands of women who made this research possible. Your participation, engagement, and trust are helping to pave the way for a future in which breast cancer screening is more personal, more precise, and more empowering for everyone.
- Access the Research Summary in JAMA.
- Access the Full Text Article in JAMA; Published Online: December 12, 2025;
- Access the Full Text Article about our genetic test results in JAMA
- Read about our genetic testing results in our blog article
