Dr. Laura Esserman

Transcript, February 3, 2026

Joelle Kaufman (00:02.568)

Welcome back to Kicking Cancer’s Ass, where we give you the insights, power, and hope you need with real stories, cutting edge science, and proven suggestions. I’m Joelle Kaufman, and today we’re looking at research that could change breast cancer screening for everyone, for your daughters, your granddaughters, everyone. In fact, 47,000 women just proved we can personalize screening based on your actual risk, not one size fits all guidelines.

And the visionary behind that study, the leader of it, joins me today. She’s also my breast surgeon, Dr. Laura Esserman. She is a surgeon, a researcher, an innovator. She leads the UCSF Breast Cancer Center. She pioneered nipple-sparing mastectomies. She leads the WISDOM study, the iSpy study, and she founded the Rise Up for Breast Cancer and Women’s Health Conference. Laura, Dr. Esserman.

Thanks for joining me.

Dr. Laura Esserman (01:01.272)

Thanks for having me, Joelle.

Joelle Kaufman (01:03.216)

It’s good to see you. Well, let’s go to that very, that moment of insight. Can you walk us through what you saw that made you think, we need to completely change how we screen for breast cancer?

Dr. Laura Esserman (01:17.966)

think there’s a number of things that over the years, think that, you know, our hope was that by screening, what we would do is find many more early stage cancers and reduce the number of late stage cancers. And indeed, we found many more early stage cancers, but we did not see the reduction in late stage cancers that we should have seen.

In addition, as you know, on the iSpy trial, we mostly, I mean, we only have women with high risk cancers who have stage two and three disease. If screening were so perfect, there would be no ice by trial. There’d be no need for an ice by trial. So clearly something was amiss. I teamed up with Ian Thompson in 2008 and we published in 2009 an article called Rethinking Screening.

And what I tried to do was apply the lessons from prostate cancer screening. As everyone is familiar with this example, screening, while it can be effective and trying to reduce the chance of finding late-stage prostate cancer, they had a huge increase in early-stage cancers. in fact, so much so that what was happening is that people were going to the, having, you know, increasing the mortality rate because people were having surgery that they didn’t need.