Dr Funmi Olopade: Breast Cancer Screening Is Not One Size Fits All

The WISDOM study—Women Informed to Screen Depending On Measures of Risk—was launched to test a personalized approach to screening compared with annual mammograms. Funmi Olopade, MD, FACP, is a professor of medicine and human genetics and founding director of the Center for Clinical Cancer Genetics and Global Health at the University of Chicago Medical Center, and a co-investigator of WISDOM. Here, she explains how different populations are at different risk for breast cancer and the importance of informed screening.

Transcript

Can you discuss the particular risks of breast cancer in different populations?

When we talk about breast cancer not being one disease, that's really why it's nice to have everyone participate. As I told you, I'm on the south side of Chicago. Right next to us is Chinatown, and we know the kinds of breast cancer that Asian women have is actually much, much different in the sense that they tend to have a lot of HER2+ [human epidermal growth factor receptor 2] breast cancer. But when we treat them, they're HER2+, they’re estrogen receptor positive; they actually have the best outcome because we have HER2 targeted therapy. Why is that the case? As we are studying breast cancer disparity, we are actually saying, why can't black women have the same outcome as Asian women that we treated in the same hospital? What is it about Asian women with HER2+ breast cancer? Why is it that they get a higher rate of HER2+ breast cancer?

We've learned that not one size fits all. Hispanic women and women who are new immigrants to the city of Chicago, you know the most important health concern for them? Cervical cancer, because these women are not getting screened; these women have advanced cervical cancer. But when they get breast cancer, they actually have a lower risk for breast cancer. While we're learning which women need to get screened every 2 years, we’re also learning that some women need to get screened every 6 months. That is the beauty of the WISDOM study: one size doesn't fit all. And we're going to learn a lot on who needs more [screening] gets screened every 6 months, versus who needs less gets screened every 2 years, versus who just wants to come every year. This is why women informed to screen based on measures of risk is really innovative, and I hope that we will learn a lot from these 100,000 women and that managed care organizations will learn to pay for tests based on what we have learned doing this or generating the evidence to inform practice.