If you know a woman over 40, you’ve probably heard of a mammogram — the most commonly recommended annual procedure to screen for breast cancer.
Mammograms aren’t sexy or fun, but the reason we get them is to try to find breast cancer early when it is more treatable. But mammograms are not perfect. Over the course of 10 years of annual screening, a woman has a 50 percent chance of being called back after a mammogram, with a 2 percent chance this turns out to be cancer. According to recent research, “more than half of cancer-free women will be...summoned back for more testing because of false-positive results.” Think about how scary that is! The only kind of response you want after being screened for cancer is, “Everything looks good!” — not “Please come in for additional testing.”
And mammograms cannot necessarily find the really aggressive cancers early. Those kinds of breast cancer can show up between normal screening, which is why women who find a lump should still go see their doctor even if they have recently had a normal mammogram.
Mammograms will also find more nonthreatening cancers (breast cancer is not one disease — it runs the continuum, from indolent to aggressive).The trick is making sure we don’t over-treat the ones that pose no serious threat.
Today, there’s no clear solution. Some doctors and organizations recommend annual screening for women starting at 40, and others recommend screening every other year starting at 50. Wait until women turn 50 to start screening, and you’ll reduce the number of misdiagnoses — but you’ll also miss some cases of cancer. Screen every other year, and you face the same risks. So what’s the answer?
Not all women are the same. We have different risk factors, different genetic makeups, different family histories. So why do we all get the same annual mammogram?
That’s where the UC-wide Wisdom Study comes in. By recruiting its target of 100,000 women throughout California and the Midwest between the ages of 40-74, the Wisdom (Women Informed to Screen Depending on Measures of Risk) Study hopes to uncover whether annual mammograms really are the best way to screen for breast cancer, or whether a more personalized approach — driven by the data attached to each woman’s genetic makeup, family history, and risk factors — could deliver better results.
“How do you use technology to make sure no one slips through the cracks?” says Dr. Laura Esserman, Director of the UCSF Breast Care Center and Principal Investigator of the Wisdom Study. “That’s what the whole precision medicine idea is about: that you don’t treat everybody the same.”
Salesforce is partnering with UCSF to provide the underlying technology for the study. It’s a natural fit: Salesforce has developed industry-leading technologies to make sales, service, and marketing faster, more actionable, and more personalized. Applying these same technologies to medicine can bring the same level of optimization to how we screen, prevent, and treat breast cancer.
“Salesforce platform is allowing us to conduct trials in a completely different way,” Dr. Esserman explains. “We can conduct a trial of 100,000 women. We can do it fast, and we can do it very efficiently.” By capturing individualized data in real time, physicians and researchers can make impactful decisions about each individual’s health care, rather than using broad assumptions to provide generalized care.
“We have made enormous progress in the treatment of breast cancer, but it is still not good enough,” Dr. Esserman says. “There are 35,000 women a year, in the United States alone, who are still dying of breast cancer. Until that stops, we have to do better. We encourage women to join this landmark study to help us figure out how to best approach breast cancer screening, and most importantly, how to improve it through Wisdom.”
Donate to the Wisdom Study. Currently, our goal is to raise $1 million to support the study through its duration.
If you know a woman between the ages of 40-74 who receives her care at a UC Medical Center and has never had cancer, encourage her to sign up for the Wisdom Study. She will be asked to complete a health history questionnaire and sign a consent form before being assigned to a Study Group. The study will open in early 2016, but she can get on our list now!
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