New Study Highlights Risk-Based Screening — and the Role of Nutrition in Breast Health

A large new clinical trial published in the Journal of the American Medical Association (JAMA) is raising an important question: Do all women need annual mammograms, or should screening be tailored to individual risk?

The study does not suggest abandoning mammograms. Instead, it points toward a more personalized approach — while also reminding us that screening is only one part of breast-cancer prevention. Nutrition, inflammation control, metabolic health, and hormone balance play critical roles as well.

Overview of the Study: The WISDOM Trial

The WISDOM (Women Informed to Screen Depending on Measures of Risk) trial followed over 28,000 women aged 40–74 across the U.S.

Participants were divided into two groups:

Standard Screening Group

• Annual mammograms for all women

Risk-Based Screening Group

Screening recommendations were based on:

• Genetic testing (nine breast-cancer-related genes)
• Family history
• Hormonal and reproductive factors
• Other health indicators

Based on risk:

• High-risk women: Alternated mammograms and MRI every 6 months
• Moderate risk: Annual mammograms
• Average risk: Mammograms every 2 years
• Low risk: Screening delayed until age 50 or until risk increased

Key Findings

• No increase in advanced (stage 2B or higher) cancers in the risk-based group
• Overall biopsy rates were not reduced, though distribution differed
• High-risk women had more imaging and biopsies; low-risk women had fewer

Researchers concluded that risk-based screening was as safe as annual screening when measuring late-stage cancer outcomes.

Why Some Experts Urge Caution

Radiologists point out an important limitation:
The study did not fully assess whether early-stage cancers (stage 0–2A) were detected as effectively.

Over 60% of breast cancers are diagnosed at early stages, where cure rates exceed 90%. Detecting cancer earlier, not merely avoiding late-stage disease, is the primary value of screening.

Additionally, labeling women under 50 as “low risk” may be problematic, as breast cancer rates are rising in younger women.

Breast Health Is More Than Imaging

Regardless of screening frequency, breast-cancer risk is strongly influenced by metabolic, inflammatory, and hormonal factors — many of which are modifiable.

Nutritional Therapy for Breast Health

A breast-protective nutritional strategy focuses on reducing inflammation, improving estrogen metabolism, and supporting immune surveillance.

Key Dietary Principles

• High-fiber diet (25–35 g/day) to support estrogen clearance
  • Vegetables, berries, legumes, ground flaxseed
• Cruciferous vegetables (broccoli, cauliflower, Brussels sprouts, cabbage)
  • Support healthy estrogen detoxification pathways
• Healthy fats, especially omega-3 fatty acids
  • Fatty fish, olive oil, walnuts
• Adequate protein to support detoxification and immune repair
• Limit ultra-processed foods, refined sugars, and alcohol, all of which increase estrogen and inflammation

Nutrients That Support Breast Tissue and Cellular Health

• Vitamin D – Associated with lower breast-cancer risk and improved immune regulation
• Iodine – Important for breast tissue integrity (deficiency is common)
• Magnesium – Supports DNA repair and hormone balance
• Omega-3 fatty acids – Reduce inflammatory signaling
• Sulforaphane (from cruciferous vegetables) – Supports detoxification enzymes

All supplementation should be individualized, especially for women with prior breast findings.

Lifestyle Factors That Matter as Much as Screening

• Maintain healthy body composition (excess body fat increases estrogen production)
• Strength training and regular movement
• Limit alcohol (even moderate intake raises breast-cancer risk)
• Address insulin resistance and metabolic syndrome
• Manage chronic stress, which affects immune surveillance and hormone signaling

Bottom Line

Risk-based mammography may be a safe alternative to annual screening for some women — but it does not replace the importance of early detection.

More importantly, screening alone does not prevent cancer. A comprehensive approach that includes nutrition, lifestyle, metabolic health, and individualized screening decisions offers the greatest long-term protection.

Women should make screening decisions in partnership with their healthcare provider, considering both imaging and modifiable risk factors.

Keefe Clinic

5016 S. 79th E. Avenue
Phone: 918-663-1111
Fax: 918-663-2129
Email: docjohn@keefeclinic.com