The Karma research group at Karolinska Institutet is creating the world’s best-characterized breast cancer cohort. The aim is to reduce the mortality and incidence in breast cancer through translational research focusing on breast cancer prevention.


Karma launch Karisma, a randomized clinical trial, to identify an optimal Tamoxifen dose for reducing risk of breast cancer.

Tamoxifen has been used for several years as adjuvant therapy for women diagnosed with breast cancer. Tamoxifen was introduced already in the 1970s and reduces the risk of breast cancer recurrence with approximately 30%. Recent studies also indicate that use of Tamoxifen as primary prevention for healthy women at high risk reduce breast cancer incidence.

Despite the remarkable risk reduction in preventive studies, primary preventive strategies are scarcely part of clinical routine. There are several possible reasons for the reluctance. The major one being that the side effects of these therapies are not trivial. Serious side effects could only be acceptable for those that benefit from therapy, that is, there is a need of identifying women at high risk.

Also, there is not a consensus on dose needed in the preventive setting. So far only full therapeutic dose has been tested and no attempts have been made to determine if lower doses prevent women from being diagnosed with breast cancer.

As a first step toward a larger prospective study the Karma group are now planning to launch a randomized, double-blind, placebo controlled trial to investigate the mammographic density reduction at different doses of Tamoxifen.

Our aim is to identify an optimal Tamoxifen dose for reducing risk of breast cancer. Mammographic density reduction will be used as a proxy for therapy response and thereby indirectly incidence.

A pilot study started march 2015 and is ongoing. A roll-out of a full scale trial is planned to be be launched during 2016.


Karma researchers use exome sequencing of plasma DNA for non-invasive monitoring of tumor burden

Non-invasive monitoring of tumor burden hold great promise for early detection of recurrent breast cancer. Karma researchers recently evaluated and improved exome sequencing to interrogate trace amounts of breast tumors in the plasma of breast cancer patients. “We are encourage by the results”, says Daniel Klevebring, lead author of the study. The researchers are now planning a larger study to investigate the use of exome sequencing of plasma in a primary setting.

Published in PlosOne, Aug 2014. Link to the published paper:

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0104417


Karma validates volumetric breast density measurement tool

KARMA is the first study validating the performance of a volumetric breast density software (VolparaDensity) in a large-scale setting. Results of the study show that distributions of volumetric density are similar across different vendor platforms and that Volpara breast density is associated with established density determinants and breast cancer risk.

Link to published article:

Cancer Epidemiol Biomarkers Prev. 2014 Sep;23(9):1764-72. doi: 10.1158/1055-9965.EPI-13-1219. Epub 2014 Jul 10. Link to Pubmed: http://www.ncbi.nlm.nih.gov/pubmed/25012995


Karma plans a randomized clinical trial to investigate the effect of different doses of Tamoxifen through measuring the decrease of breast density in healthy women.

Tamoxifen has been used for several years as adjuvant therapy for women diagnosed with breast cancer. Tamoxifen was introduced already in the 1970s and reduces the risk of breast cancer recurrence with approximately 30%. Recent studies also indicate that use of Tamoxifen as primary prevention for healthy women at high risk reduce breast cancer incidence.

Our aim is to identify an optimal Tamoxifen dose for reducing risk of breast cancer. Mammographic density reduction will be used as a proxy for therapy response and thereby indirectly incidence.

The clinical trial is in planning phase and will be launched during 2015


Breast cancer researcher connected to Karma wins L’Oreal women’s science fellowship

Dr Li Jingmei, 31, received this year’s UNESCO-L’Oreal International For Women In Science Fellowship, one of 15 women scientists around the world to do so. Li Jingmei currently work as postdoctoral research fellow at the Agency for Science, Technology and Research’s Genome Institute of Singapore, but have strong connections to Karolinska Institutet and the Karma-group

She will receive her award at a ceremony in Paris this month.

With her US$40,000 award, Dr Li will spend two years at Karolinska Institutet in Sweden, where she previously completed her doctorate in medical science.

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Dr Li Jingmei with mammogram images, which she studies to see how breast density predicts cancer risks. A young breast cancer researcher from Singapore will soon have the chance to continue her research on the data from the Karma cohort, thanks to a prestigious international science fellowship. — PHOTO:  L’OREAL SINGAPOR

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