UCSF trial may create personalized breast cancer screenings

SAN FRANCISCO (KGO) -- A Bay Area research group is about to take on one of the most controversial questions in women's health -- how frequently should women be screened for breast cancer? This time the goal is to do more than issue a blanket recommendation.

Susan Ashton is getting the routine mammogram many women over 40 years of age schedule once a year. But her scan is part of a groundbreaking effort to reexamine the benefits of that ritual.

"I'm very lucky," she said. "My risks are low for breast cancer."

Ashton is joining a clinical trial soon to get underway at University of California San Francisco. Dr. Carlie Thompson is collecting information that will be used to create a personalized breast cancer risk assessment for individual women in the study.

They take notes on a woman's family history first, then the women have a mammogram to measure breast density, and finally -- for the first time -- a DNA sample will be taken that will allow researchers to scour a patient's genome for markers linked to elevated cancer risk.

"We're trying to find the best way to screen women for breast cancer," Thompson said. "It was with that risk profile that will determine how often a woman should be screened for breast cancer, with what modality, mammogram, MRI, and how frequently."

The question of how often individual women should be screened for breast cancer has become a lightning rod over the last several years. In fact, when a federal panel suggested that some women might only need a mammogram every other year, it touched off a debate that spread all the way to Congress.

But UCSF cancer surgeon Dr. Laura Esserman says the goal of this study isn't to find a new one-size-fits-all breast screening standard for every woman, but to use recent breakthroughs in genetics and precision medicine to make screening more efficient.

"We want to test, is it just as safe to screen people in a more risk-based approach? And is it actually better?" Esserman explained.

Esserman argues that a better understanding of cancer risks could spare many women from unnecessary screening and treatment while putting more effort into catching life-threatening cancers in higher-risk women.

"If your risk is particularly high, like you have a mutation like BRC1 or BRC2, or some other combination of factors that make you at extremely high risk, you perhaps should be screened every six months," said Esserman.

Women in the study can receive either traditional screening such as yearly mammograms or risk-based screening, which could mean more or less imaging depending on their profile.

Ashton simply hopes her participation leads to new answers. She said she's involved "because of my interest in making the research happen, so the resources can be allocated where they need to be allocated."

The trial will be known as "Wisdom" and is targeted to start late this year. Researchers will be working to recruit women for both types of screenings. Women can enroll through the Athena Breast Network.