Screening for Breast Cancer

To the Editor The prevailing one-size-fits-all paradigm of breast cancer screening—largely based on age and fixed intervals—was designed during an era with limited risk stratification, few prevention pathways, and limited ability to tailor imaging intensity. Pragmatic randomized clinical trials, such as WISDOM, are therefore essential to generate evidence with a prevention strategy that can reallocate resources from women at lower risk of breast cancer to those at higher risk.