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Dr Laura Esserman, UCSF Breast Surgeon and Oncologist, Founder of the Wisdom Credit Study – Vatsala Goel for Time
When it comes to breast cancer, the sad truth is that despite all the advances in new treatments and more sophisticated means of imaging breast tissue, doctors are still not very good at selecting women who are most at risk. to contract the disease from those at low risk. . All women are screened for breast cancer based on the grossest risk factor available: age.
This has led to a disturbing paradox. While breast cancer death rates in the United States fell 40% between 1989 and 2017, this success may have come at a price, resulting in a Goldilocks treatment scenario in which only some women receive the testing and treatment they need. An increasing proportion of cancers are not detected and treated early enough, or conversely, still others may be overtreated for growths detected by sophisticated screening that will never develop into problematic cancers. General advice that women start regular breast cancer screening at age 50 turns out to be a rather poor way of identifying those most at risk of contracting the disease..
“The only way to do better is to know better,” says Dr. Laura Esserman, director of the Carol Frank Buck Breast Cancer Centers at the University of California, San Francisco. Esserman, along with his team, has spent the past few years finding a way to get physicians out of the same screening and treatment routine that has defined breast cancer care for decades. To do this, Esserman designed the WISDOM (Women Informed About Screening Based On Risk Measures) study to fill the most glaring gaps in our knowledge about breast cancer management.
Rather than starting with broad screening and treatment plans and integrating the diverse population of women into those policies, regardless of their genetic backgrounds, lifestyle, and other risk factors, Esserman turns the story around and begins with the patient first. The idea is to create a personalized way to screen for and treat breast cancer that takes into account the latest scientific advances and the latest developments in targeted cancer drugs, as well as the medical history and health status of the woman. wife.
With WISDOM, Esserman hopes to gather the data needed to formalize this precision medicine strategy, creating recommendations for a more personalized approach to breast care that allows physicians to find women most at risk of developing aggressive disease and Offer them the right treatment. as quickly as possible. TIME has chronicled Esserman’s work on WISDOM since its inception in 2015 and launch in 2016; she was named to TIME 100 Most Influential People List in 2016.
Esserman plans to enroll 100,000 women in the study and randomly assign them for annual screening or a more personalized plan for five years. So far, 35,000 women, including those from groups under-represented in breast cancer research, such as African American women and military veterans, have joined. (Marc and Lynne Benioff, the co-chairs and owners of TIME, have been philanthropic supporters of Dr. Esserman’s breast cancer research. The WISDOM study receives software support from Salesforce, of which Marc Benioff is president and CEO.)
In a series of short videos for Breast Cancer Awareness Month in October, we will meet several women who participate in WISDOM and explore what they have learned about their own breast cancer risk and how the knowledge they have acquired have changed. how they perceive the disease, from a woman who thought she was at high risk due to a family history of breast cancer, but turned out not to need the intensive screening she was receiving, to a woman whose genes hid a predisposition to the disease she would never have learned otherwise, to African-American women at higher risk for a more aggressive form of cancer.
Bookmark this page and come back to it throughout the month to see the videos as we publish them.
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