Ongoing research

For more information than what is given below, please contact Per Hall (

KARISMA Endoxifen

The aim of the KARISMA Endoxifen trial is to compare two different doses of Z-endoxifen with placebo, regarding effect on mammographic density and side effects. Tamoxifen has been used to prevent breast cancer recurrence in patients for >30 years. Healthy women who take tamoxifen 20 mg daily for 5 years get a 30-40% reduced risk of breast cancer, but the medication may cause side effects. Read more

The Karma Cohort

The Karma Cohort is a prospective screening cohort consisting of 70,877 women, initiated in 2011 [Gabrielson et al. 2017] with the overarching goal to reduce the incidence and mortality of breast cancer by focusing on individualised prevention and screening. Read more.

Karma Intervention Study – Karisma

Karisma (the Karma Intervention Study) aims to reduce the incidence of breast cancer by preventing breast cancer using the anti-estrogen drug tamoxifen. Read more.

Karma CREME – A Phase 2 trial on topical endoxifen

Our overall aim of the Karisma trial is to reduce the risk of breast cancer using a lower dose of tamoxifen than the accepted 20 mg. Read more.

Karma Risk – Individual risk prediction of breast cancer

We have developed a new model for individualised short-term risk prediction, called CAD2Y, combining mammographic density and mammographic features with classical risk factors for breast cancer. Good risk prediction models can be used in clinic to predict the individual risk of developing breast cancer. The goal is to implement CAD2Y in individualised screening. Read more.

Karma Risk Communication – Acceptability and view of individual risk prediction and risk based screening among professionals and healthy women

The Karma group aim to collect questionnaire data from the Karma participants on whether they want to know about their individual risk of breast cancer, and if so, how and by whom the risk should be communicated to the women.  Read more.

Karma MRI – Abbreviated MRI protocol

At South General Hospital, Stockholm, the Karma Group is testing if a short protocol for magnetic resonance imaging (MRI) is as good as a full protocol. Read more.

Karma STRATUS – High throughput measurement of mammographic density

By measurements from raw images using FDA approved software iCAD wehave now developed a new algorithm called STRATUS, which measures density on all type of images, regardless of vendor, and controls for non-biological differences seen in time series of mammograms from the same women. STRATUS has the potential to become a useful tool for epidemiological studies and clinical follow-up. Read more.

Karma Normal – Analyses of normal breast tissue

Karma Normal is a biopsy-based study of 161 healthy Karma participants without prior history of breast cancer. The overall aim of Karma Normal is to understand the biological mechanisms underlying mammographic density as a risk factor for breast cancer. Read more.

Karma Plasma Proteomics and Hormone Metabolomics – Identifying circulating markers of breast cancer risk

Using the rich collection of plasma in Karma we are conducting proteomic profiling and endogenous hormone profiling to identify putative proteins and biomarkers associated with mammographic density and breast cancer risk. Read more.

Karma iCOGS – Identification of genetic determinants of breast cancer

Genetic alterations that predispose women for later developing breast cancer are studied in collaboration with the Breast Cancer Association Consortium (BCAC) (, the University of Cambridge and the European Commission funded COGS project ( consortium includes more than 550 researchers at 300 research facilities across the globe. Read more.