Women: Could you spare six minutes if you knew it could save your life? What if those six minutes had far reaching benefit and it could also save the lives of other women around the world?
“Up to 90 percent of women who are diagnosed with breast cancer have no identifiable risk factors for breast cancer or family history of the disease,” said
Haydee Ojeda-Fournier, MD, medical director of the breast imaging section at Moores Cancer Center at UC San Diego Health. “A mammogram takes six minutes, just long enough for us to obtain two images of each breast, and just long enough to save a life.”
Lilly Lidot’s sister did not get regular checkups, so when her sister’s cancer was diagnosed it had already spread to her brain. Breast cancers that are found through mammograms have a 95 percent chance of resolution but that drops to 50 percent if the disease is found by a patient or a physician, said Ojeda. If a lump can be felt or has metastasized (spread), it’s likely a more advanced malignancy.
Unfortunately, Lidot’s sister’s disease was advanced and she died in 2010.
Lidot, now 62, has received yearly mammograms since she was 40 years old. When she received an invitation from UC San Diego Health to participate in the Women Informed to Screen Depending on Measures of Risk (WISDOM) clinical trial she immediately signed up. Its aim is to uncover whether annual mammograms 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.
“Scientific research is a great way to have the facts that determine why and how often women should get mammograms,” said Lidot. “I know I’m going to get a mammogram regularly anyways, so I might as well be part of important research. The results will benefit woman-kind around the world and that’s something I can get behind.”
When and whether to get a mammogram has been an ongoing discussion in the health field. That is why the five University of California medical centers, including Moores Cancer Center at UC San Diego Health, joined together to recruit 100,000 women in California to be part of WISDOM.
“Screening guidelines for breast cancer have changed many times over recent years and seem to be in a constant state of flux,” said Andrea Z. LaCroix, PhD, professor and chief of epidemiology in the department of Family Medicine and Public Health at University of California San Diego School of Medicine and co-principal investigator in the study. “The WISDOM trial’s goal is to test annual screening versus a personalized schedule based on a woman’s clinical and genetic risk factors for breast cancer. The study should determine which strategy produces the most benefit for women and the least harms.”
Lidot said some women do not go for regular mammograms because they think it will hurt but she said it is no worse than a vaccine. The discomfort might come when the breast is compressed as an image is taken. At Moores Cancer Center, Ojeda and her team attempt to reduce discomfort and stress by taking the patient step by step, quickly using the latest digital imaging technology. A “sensory suit” with a video panel, nature sounds and aromatherapy helps to create a soothing environment.
“We have dedicated technologists that move with precision to obtain images and work with the patient to make them as comfortable as possible and our radiologists are available to answer any questions,” said Ojeda.
To participate in the WISDOM trial, women must be between 40 and 74 years old and not have had breast cancer. Women do not need to be a patient at UC Health medical centers. They can have their mammograms completed by their physician or they may go to a UC Health center.
The first step is for women to fill out an online questionnaire that covers health and family history. Each participant is then invited to be randomized (assigned by chance) to either the personalized or the annual screening arm of the study. However, if a participant has a strong preference, she is welcome to choose her own study arm. Women in the annual screening arm will have annual mammograms; those in the personalized arm will be assessed for their risk of developing breast cancer, and given a genetic test. No woman will be screened less often than the United States Preventive Services Task Force guidelines recommend.
“If you don’t have cancer in your family you may think it won’t happen to you. You may think cancer happens to other people,” said Lidot. “I was participating in walks that fundraised for breast cancer research 20 years ago. We just did it because we thought it was a good cause. Now I know that it’s important to get a mammogram. Even if you don’t want to be part of this study, just get your mammogram.”
At UC San Diego Health, the recommendation is that women screen for breast cancer every year starting at age 40.
“We want women to help us clarify mammogram guidelines and in the process learn about their own personal risk for breast cancer,” said LaCroix. “Women need breast cancer screening programs that truly reduce their risk of dying from breast cancer and do not result in unnecessary procedures, stress, surgeries and other dangers.”
For more information or to become a study participant visit www.wisdomstudy.org.
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