New Tools Aim to Spot Breast Cancer Earlier

Margaret Mack, a 38-year-old child therapist with no breast cancer in her family history, joined a screening trial last September. A saliva test revealed a PALB2 variant, which can carry a lifetime breast cancer risk as high as 58 percent. The finding placed Mack in the highest-risk category of WISDOM, an ongoing study that started in 2016.

WISDOM evaluates women ages 30 to 74 using genetic findings, breast density, and health and demographic details, including age, race, and family history. Participants are classified as low, average, elevated, or high risk. Those in Mack’s category receive screening at six-month intervals, switching between a mammogram and an MRI. At a high-risk clinic, Mack underwent a mammogram, ultrasound, and MRI. Only the MRI detected ductal carcinoma in situ. Her condition was stage 0 but high-grade, meaning the abnormal cells posed a risk of spreading rapidly into nearby tissue.

Breast cancer affects one out of every eight women in the U.S. Most organizations currently support annual mammograms beginning at 40, although recommendations have repeatedly shifted. The American Cancer Society moved its annual-screening starting age from 40 to 45 in 2015, while allowing women 40 to 44 to choose. In 2024, the United States Preventive Services Task Force lowered its starting age from 50 to 40 and recommended screening every other year. Meanwhile, incidence among women under 50 increased 1.4 percent from 2013 through 2022, compared with 1 percent across all ages. Cases before 40 still account for about 4 percent, supporting researchers’ interest in identifying individual risk instead of relying on age alone.