"Why can't we build a contraceptive that reduces breast cancer risk? That's the way to get rid of breast cancer. I don't want to just keep treating it. I want to prevent it altogether."
In this groundbreaking episode, Dr. Laura Esserman, Director of the UCSF Breast Cancer Center, joins Joelle Kaufman to reveal how her 47,000-patient WISDOM study just proved we can eliminate late-stage breast cancer through risk-based screening—and why the medical establishment resisted her every step of the way.
They dive deep into:
WISDOM study results: Zero stage 2B+ cancers in highest-risk women screened every 6 months versus annual age-based protocols
Population genetic testing economics: now cheaper than a single mammogram, done once, reveals 30% of mutation carriers have no family history
Polygenic risk scores (PRS) changing screening recommendations for 15% of women beyond single-gene BRCA testing
AI breast density algorithms identifying the actual 10% who need supplemental screening—not the 50-60% currently over-screened
Anti-progestin medications like mifeprestone already used for fibroids and endometriosis are being repurposed as breast cancer prevention tools
Intermediate endpoint frameworks for prevention drugs modeled on cardiology's blood pressure and cholesterol standards
Why 25% of I-SPY trial patients are under 40 and what that reveals about current screening failures
The $4-5 million funding gap is blocking WISDOM 2.0 enrollment while waiting 1-2 years for insurance guideline changes
From proving precision screening works to building prevention pathways that could cut annual diagnoses from 320,000 to 150,000, this is essential listening for anyone rethinking how we approach women's health.
Don't wait for guidelines to catch up. Understand the science that's already proven.
Support the WISDOM Study—help provide genetic testing and personalized screening to women while we wait for insurance guidelines to catch up: https://giving.ucsf.edu/fund/wisdom