Short presentation of current research
My overall and most important scientific goal is to lower the incidence and mortality of breast cancer, a potentially fatal disease that is increasing dramatically throughout the world. In order to do this, a tool that identifies the individual risk of breast cancer has to be identified. Such a tool should answer the question "-Who are the women that will be diagnosed with breast cancer?". When this is done, means to influence to influence incidence and mortality has to be developed and tested.
The Karma project
The Karma project is conducted in close collaboration with four hospitals in Sweden, Södersjukhuset, Helsingborg, Landskrona and Lund. Women attending a mammography, screening or clinical, at any of these hospitals are invited to participate in the Karma project. Upon acceptance, participants fill out a web-based questionnaire and donate blood. We also ask for their informed consent to store the processed and raw mammograms and to link the personal ID to the Swedish Inpatient, Prescription, Cancer, Emigration/Immigration and Cause of Death Registers. We are also allowed to link participants to the nationwide Breast Cancer Registry (INCA).
The COGS project
I am also the coordinator of COGS - The Collaborative Oncological Gene-environment Study - a European Commission funded project. The overall objectives of COGS are a) to determine the genetic determinants of breast, ovarian and prostate cancer, b) to assess gene and environment interaction, c) to assess inheritance of prognosis, d) to develop risk models to allow prediction of breast, ovarian and prostate cancer and e) to assess the organizational, ethical, legal and social implications of preventive initiatives.
By 2012 more than 250,000 individuals had been genotyped using the 200,000 SNPs iCOGS chip, and the first major publications emerged in March 2013 (see below).
Large-scale genotyping identifies 41 new loci associated with breast cancer risk.
Nat Genet 2013;45:353-61.
Multiple independent variants at the TERT locus are associated with telomere length and risks of breast and ovarian cancer.
Nat Genet 2013;45:371-84.
Genome-wide association studies identify four ER negative-specific breast cancer risk loci.
Nat Genet 2013;45:392-8.
I am a professor of radiation epidemiology, lately with a focus on radiation associated late adverse health effects in women diagnosed with breast cancer. Recently, we managed to estimate the dose dependent risk of a myocardial infarction and identify particularly susceptible subgroups of women.
Risk of ischemic heart disease in women after radiotherapy for breast cancer.
N Engl J Med 2013;368:987-98.
Mammographic density, the radiolucent part of the mammogram, consists of glandular and connective tissue. Mammographic density is a strong risk factor for breast and is influenced by age, BMI and hormone replacement therapy. The anti-hormonal therapy administrated to breast cancer patients post surgery decreases density. We have recently shown that a density decrease while on adjuvant tamoxifen is a strong prognosticator and influences breast cancer survival beyond 15 years of diagnosis.
Mammographic Density Reduction Is a Prognostic Marker of Response to Adjuvant Tamoxifen Therapy in Postmenopausal Patients With Breast Cancer.
J Clin Oncol 2013.
I conduct most of my projects in close collaboration with Professor Kamila Czene. Our group consists of 10 post docs and students, 9 research nurses, data base managers, project leaders and administrative personal. Most analyses are conducted in collaboration with statisticians at the department. We both have extensive and intense international collaboration.