Abstract PS3-02-19: Primary Care Provider Input On Personalized Breast Cancer Screening Recommendations in WISDOM 1.0: A Nationwide Risk-Based Breast Cancer Screening Trial

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Abstract Background The Women Informed to Screen Depending on Measures of risk (WISDOM) Study 1.0 (2016-2023; NCT02620852) is testing a novel, personalized approach to breast cancer screening compared to annual mammography. WISDOM, a large-scale screening trial, enrolled women ages 40-74 with no personal history of breast cancer using a randomized, preference tolerant trial design, reflecting the heterogeneity of the U.S. population. The goal of this analysis is to evaluate whether women discussed WISDOM screening recommendations with their primary care provider, factors associated with discussion, and whether primary care providers (PCPS) agreed or disagreed with the screening recommendation. Methods We analyzed participant-reported responses among the first 15,000 WISDOM participants who completed patient-centered outcomes surveys at baseline, at the time of they received their screening recommendation, and at first annual follow-up. The annual survey asked about discussing the trial screening assignment with their PCPS and the reaction of their PCPS to the screening assignment (Likert 5 scale from Strongly Disagreed to Strongly Agreed). These items were compared between the randomized arms (annual versus personal risk-based) and across the study breast cancer screening assignments (6 months with MRI, Yearly with Risk-Reduction, Yearly, Two Years, Delayed Screening). Results Participants in the risk-based screening arm were significantly more likely to report discussing the screening recommendation with their PCP (35.6%, 2708/7610) compared to those in the annual arm (19.0%, 1308/6888; p < 0.001). PCPS agreement with the screening recommendation also varied by arm. In the annual group, 75.7% of participants reported their PCPS agreed or strongly agreed with the recommendation and only 2.5% disagreed, In the risk-based group, 58.6% agreed and 16% disagreed. Among participants in the risk-based arm, discussion rates with PCPS and level of PCPS agreement differed by screening recommendation. The highest rate of discussion occurred in those assigned to 6 months with MRI (71.1%), followed by Yearly with risk-reduction (50.3%), Two Years (34.6%), Yearly (29.6%) and Delayed (32.4%). Disagreement was highest in those identified at lowest risk, Delayed Screening (24.2%) and those with the Two Year (16.1%) and disagreement was lowest with the higher screening recommendations wherein Yearly (1%) and 6 Month with MRI (5.6%) disagreed. Conclusion/Discussion Women often discuss breast cancer screening recommendations with their primary care providers, particularly risk-based recommendations. Data from WISDOM 1.0 show PCPS had stronger agreement more frequent screening recommendations and disagreement with less frequent intervals. These findings suggest that education to increase primary care physician familiarity with personalized screening approaches may enhance the implementation and acceptance of risk-based strategies in clinical practice. Citation Format: A. Naeim, A. Stanton, K. Sepucha, S. Vangala, A. Petruse, L. Madlensky, A. S. Fiscalini, L. J. Esserman, M. Eklund, K. Ross, D. Goodman-Gruen, J. Tice, E. Ziv, Y. Shieh, L. van 't Veer, A. Kaster, A. M. Blanco, O. I. Olopade, M. Scheuner, B. Tong, L. Sabacan, J. Atamer, H. Harvey, R. A. Hiatt, A. D. Borowsky, J. Esserman, H. Anton-Culver, A. LaCroix, H. L. Park, B. A. Parker, R. Lancaster, WISDOM Investigators and Advocate Partners, N. Wenger. Primary Care Provider Input On Personalized Breast Cancer Screening Recommendations in WISDOM 1.0: A Nationwide Risk-Based Breast Cancer Screening Trial [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS3-02-19.

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