Our goal is to prevent breast cancer

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The Karma Study is about preventing breast cancer so that fewer people suffer from the disease. The aim is to identify women at a high risk of breast cancer and offer them treatment with drugs that prevent them from developing the disease. The Karma Study has been made possible thanks to a donation from Märit and Hans Rausing.

Per Hall“About 15 years ago, I read an article that compared cancer with cardiac care. The cardiologists were described as being able to successfully find and treat risk factors for heart disease, such as hypertension and high blood lipid levels. This had enabled them to reduce incidence and mortality in their field. The oncologists, on the other hand, were a long way away from such strategies. These thoughts made an enormous impression on me. As a breast cancer specialist, I realised that the care we were providing was actually quite passive. We waited until the occurrence of the disease and only then tried to cure it. Research was largely about finding better treatment methods and about detecting the disease. 

I want to try to find breast cancer’s equivalent to hypertension and high blood lipids, and treat healthy women in order to keep them healthy. I tried in vain to raise money for such research, as everyone was sceptical about the ability to prevent breast cancer. 

However, Märit and Hans Rausing had faith in the potential of these ideas and decided to donate SEK 70 million, enough to get the Karma Study up and running. The study will produce life-saving results. Today, one Swedish woman an hour is diagnosed with breast cancer. I believe that this number can be cut by a third. 

Just over two years after the study started, we had recruited 71,000 participants from the national mammography programme. We asked each individual to describe their lifestyle factors that could increase the risk for breast cancer, such as how many children they had. We also took blood samples for genetic analysis and conducted mammograms. With this information, we were able to identify factors that increase the risk of developing breast cancer later in life. 

We have obtained very concrete results, such as that breast density (i.e. the number of mammary glands in a breast, as shown by a mammogram) demonstrably contributes to the risk. We have also identified a large number of genes that influence the risk of breast cancer, and can now, thanks to the Karma Study, more precisely ascertain an individual’s risk of getting breast cancer. 

My project is based on the idea that high-risk women will get prophylactic drug treatments to prevent the disease from developing, in the same way as people with high blood pressure and lipids are given drugs to prevent them from contracting cardiovascular disease. The drug in question is Tamoxifen, which is currently administered to prevent recurrences in women who have already had breast cancer. We are now looking into whether relatively low doses of the drug are enough to prevent the disease. Low doses produce fewer side effects, which makes it easier for high-risk women to stay on a course of prophylactic medication. 

A successful pilot study has been followed by a larger-scale study of prophylactic treatment.“

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