Can we provide better, individualized recommendations for screening? Guidelines for mammography indicate annual screening for most women, providing a “one-size-fits-all” approach to the detection of breast cancer. However, as our understanding of this disease has improved, a better picture of risk factors is now developing – some women have higher risk than others (and conversely, some have lower risk). As part of a PCORI-funded pragmatic trial, the WISDOM Study, the Center for SMART Health is helping to test different screening schedules (one based on risk, another based on age). The goals of the 100,000 subject study are to determine:

• If the risk-based screening schedule helps decrease false alarms that lead to unneeded tests or treatments;
• How women feel about using a risk-based screening schedule;
• If the type of schedule affects how much women worry about breast cancer;
• Whether women who learn that they are at high risk take other steps to reduce their chances of getting cancer; and
• How well each screening schedule detects cancer.