Your Breast Cancer Screening Might Not Need to Be Annual—Here's What a Major Study Found

If you're a woman over 40, you've probably heard the advice: get a mammogram every year. But what if that one-size-fits-all approach isn't actually the best way to catch breast cancer? A groundbreaking study just challenged that assumption, and the findings could change how millions of women approach screening.

The Study That's Reshaping Breast Cancer Screening

Researchers at the University of California, San Francisco, led by Dr. Laura Esserman, conducted one of the largest breast cancer screening trials ever. The WISDOM study followed more than 28,000 women ages 40 to 74 from all 50 states—none of whom had ever been diagnosed with breast cancer. About half received the standard annual mammogram screening, while the other half got something different: a personalized risk assessment.

That risk assessment looked at genetics, health history, lifestyle factors, and breast density to determine each woman's actual breast cancer risk. It's a more targeted approach than simply screening everyone the same way based on age alone.

How to Interpret Your Breast Cancer Screening Results

Here's the good news: risk-based screening worked just as well as annual mammograms at detecting breast cancers. In fact, women in the risk-based group had one-third fewer cancers that had advanced to later stages compared to the annual-screening group.

The study divided women into four risk categories, and screening recommendations varied based on where they fell:

• Highest risk (2% of women): Screening every 6 months, alternating between MRI and mammogram
• Elevated risk (8%): Annual mammogram starting at age 40
• Average risk (63%): Screening every two years starting at age 50
• Lowest risk: No screening recommended until age 50

Why This Matters for You

This approach could reduce anxiety, lower costs, and cut down on unnecessary follow-up testing—something many women worry about. If you're at lower risk, you might not need yearly mammograms. If you're at higher risk, you might benefit from more frequent screening or additional imaging like MRI.

Women in the highest-risk groups also received personalized counseling from breast health specialists about lifestyle changes and risk-reducing medications. Those at greatest risk were more likely to use these medications, suggesting that personalized guidance actually helps women take action.

What Women Actually Want

Here's something telling: the study included an additional 18,000 women who weren't randomly assigned but could choose their screening approach. Nearly 90% of them chose the risk-based method over other options. That suggests most women prefer a personalized approach when given the choice.

What Happens Next?

The study results, published in JAMA in December 2025, suggest that risk-based screening is a safe alternative to routine annual screening. But researchers aren't stopping here—ongoing NIH-funded clinical trials are underway to continue improving personalized screening approaches.

Dr. Esserman sums it up well: "The personalized approach begins with risk assessment, incorporating genetic, biological, and lifestyle factors, which can then guide effective prevention strategies."

The bottom line? If you're due for a screening conversation with your doctor, this is a great time to ask about your individual risk factors rather than just following a standard age-based schedule. Your breast cancer risk is unique to you—and your screening plan should be too.