Breast cancer risk prediction with a modified BOADICEA model in Danish women

Sif Ingibergsdóttir Novitski; Ole Birger Pedersen; Stig Egil Bojesen; DBDS Genomic Consortium

doi:10.1038/s41416-025-03247-3

Breast cancer risk prediction with a modified BOADICEA model in Danish women

Sif Ingibergsdóttir Novitski
, Ole Birger Pedersen
, Stig Egil Bojesen^*
, DBDS Genomic Consortium

^*Corresponding author for this work

Clinical Immunology

Research output: Contribution to journal › Article › Research › peer-review

Abstract

BACKGROUND: Breast cancer risk prediction approaches clinical practice. The BOADICEA risk model has been updated to consider common breast cancer risk variants, lifestyle/hormonal risk factors and mammographic density (MD).

METHODS: 49,494 women from the Danish Blood Donor Study were followed for up to 10 years. Modified BOADICEA risks within 5 and 10 years were calculated based on a polygenic breast cancer risk score combined with lifestyle/hormonal risk factors. MD was only known for 4608 women. Calibration was assessed by comparing observed and predicted risks. AUC and Harrell's concordance index (C-index) were used to assess discriminative ability and sensitivities and specificities were obtained for high and low-risk groups.

RESULTS: Within 5 and 10 years, 367 and 617 women had breast cancer. The 5-year model achieved an AUC of 0.80 (95% CI:0.78-0.81), sensitivity of 0.34 and specificity of 0.92 for all and an AUC of 0.61 (95% CI:0.58-0.65) for the 50-69-year-aged. For this age-group, the sensitivity was 0.46 in the 10-year model. 50% of women with the highest 5-year risk predictions, identified 94.8% of those with incident breast cancers.

CONCLUSION: The modified BOADICEA risk model provided valid risks among a large retrospective cohort of Danish women.

Original language	English
Pages (from-to)	259-268
Number of pages	10
Journal	British Journal of Cancer
Volume	134
Issue number	2
Early online date	12 Nov 2025
DOIs	https://doi.org/10.1038/s41416-025-03247-3
Publication status	Published - Jan 2026

Keywords

Adult
Aged
Breast Density
Breast Neoplasms/epidemiology
Denmark/epidemiology
Female
Humans
Life Style
Mammography
Middle Aged
Risk Assessment/methods
Risk Factors
Benefit
Registry
Brca1

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Danske forskere kan nu udpege kvinder med størst risiko for brystkræft
Pedersen, O. B. V.
28/11/25
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@article{19332cb6050f4260b3772c0adb753b81,

title = "Breast cancer risk prediction with a modified BOADICEA model in Danish women",

abstract = "BACKGROUND: Breast cancer risk prediction approaches clinical practice. The BOADICEA risk model has been updated to consider common breast cancer risk variants, lifestyle/hormonal risk factors and mammographic density (MD).METHODS: 49,494 women from the Danish Blood Donor Study were followed for up to 10 years. Modified BOADICEA risks within 5 and 10 years were calculated based on a polygenic breast cancer risk score combined with lifestyle/hormonal risk factors. MD was only known for 4608 women. Calibration was assessed by comparing observed and predicted risks. AUC and Harrell's concordance index (C-index) were used to assess discriminative ability and sensitivities and specificities were obtained for high and low-risk groups.RESULTS: Within 5 and 10 years, 367 and 617 women had breast cancer. The 5-year model achieved an AUC of 0.80 (95\% CI:0.78-0.81), sensitivity of 0.34 and specificity of 0.92 for all and an AUC of 0.61 (95\% CI:0.58-0.65) for the 50-69-year-aged. For this age-group, the sensitivity was 0.46 in the 10-year model. 50\% of women with the highest 5-year risk predictions, identified 94.8\% of those with incident breast cancers.CONCLUSION: The modified BOADICEA risk model provided valid risks among a large retrospective cohort of Danish women.",

keywords = "Adult, Aged, Breast Density, Breast Neoplasms/epidemiology, Denmark/epidemiology, Female, Humans, Life Style, Mammography, Middle Aged, Risk Assessment/methods, Risk Factors, Benefit, Registry, Brca1",

author = "Novitski, \{Sif Ingibergsd{\'o}ttir\} and Jacobsen, \{Rikke Louise\} and Timo R{\"o}der and Holm, \{Peter Christoffer\} and Michael Schwinn and Ilse Vejborg and \{von Euler-Chelpin\}, \{My Catarina\} and Elsebeth Lynge and Ostrowski, \{Sisse R\} and Erik S{\o}rensen and Pedersen, \{Ole Birger\} and Christian Erikstrup and Bitten Aagaard and Henrik Hjalgrim and Th{\'o}runn Rafnar and Kari Stefansson and Nasim Mavaddat and Lorenzo Ficorella and Antoniou, \{Antonis C\} and Henrik Ullum and Karina Banasik and S{\o}ren Brunak and Bojesen, \{Stig Egil\} and \{DBDS Genomic Consortium\}",

note = "{\textcopyright} 2025. The Author(s).",

year = "2026",

month = jan,

doi = "10.1038/s41416-025-03247-3",

language = "English",

volume = "134",

pages = "259--268",

journal = "British Journal of Cancer",

issn = "0007-0920",

publisher = "Springer Nature",

number = "2",

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T1 - Breast cancer risk prediction with a modified BOADICEA model in Danish women

AU - Novitski, Sif Ingibergsdóttir

AU - Jacobsen, Rikke Louise

AU - Röder, Timo

AU - Holm, Peter Christoffer

AU - Schwinn, Michael

AU - Vejborg, Ilse

AU - von Euler-Chelpin, My Catarina

AU - Lynge, Elsebeth

AU - Ostrowski, Sisse R

AU - Sørensen, Erik

AU - Pedersen, Ole Birger

AU - Erikstrup, Christian

AU - Aagaard, Bitten

AU - Hjalgrim, Henrik

AU - Rafnar, Thórunn

AU - Stefansson, Kari

AU - Mavaddat, Nasim

AU - Ficorella, Lorenzo

AU - Antoniou, Antonis C

AU - Ullum, Henrik

AU - Banasik, Karina

AU - Brunak, Søren

AU - Bojesen, Stig Egil

AU - DBDS Genomic Consortium

PY - 2026/1

Y1 - 2026/1

N2 - BACKGROUND: Breast cancer risk prediction approaches clinical practice. The BOADICEA risk model has been updated to consider common breast cancer risk variants, lifestyle/hormonal risk factors and mammographic density (MD).METHODS: 49,494 women from the Danish Blood Donor Study were followed for up to 10 years. Modified BOADICEA risks within 5 and 10 years were calculated based on a polygenic breast cancer risk score combined with lifestyle/hormonal risk factors. MD was only known for 4608 women. Calibration was assessed by comparing observed and predicted risks. AUC and Harrell's concordance index (C-index) were used to assess discriminative ability and sensitivities and specificities were obtained for high and low-risk groups.RESULTS: Within 5 and 10 years, 367 and 617 women had breast cancer. The 5-year model achieved an AUC of 0.80 (95% CI:0.78-0.81), sensitivity of 0.34 and specificity of 0.92 for all and an AUC of 0.61 (95% CI:0.58-0.65) for the 50-69-year-aged. For this age-group, the sensitivity was 0.46 in the 10-year model. 50% of women with the highest 5-year risk predictions, identified 94.8% of those with incident breast cancers.CONCLUSION: The modified BOADICEA risk model provided valid risks among a large retrospective cohort of Danish women.

AB - BACKGROUND: Breast cancer risk prediction approaches clinical practice. The BOADICEA risk model has been updated to consider common breast cancer risk variants, lifestyle/hormonal risk factors and mammographic density (MD).METHODS: 49,494 women from the Danish Blood Donor Study were followed for up to 10 years. Modified BOADICEA risks within 5 and 10 years were calculated based on a polygenic breast cancer risk score combined with lifestyle/hormonal risk factors. MD was only known for 4608 women. Calibration was assessed by comparing observed and predicted risks. AUC and Harrell's concordance index (C-index) were used to assess discriminative ability and sensitivities and specificities were obtained for high and low-risk groups.RESULTS: Within 5 and 10 years, 367 and 617 women had breast cancer. The 5-year model achieved an AUC of 0.80 (95% CI:0.78-0.81), sensitivity of 0.34 and specificity of 0.92 for all and an AUC of 0.61 (95% CI:0.58-0.65) for the 50-69-year-aged. For this age-group, the sensitivity was 0.46 in the 10-year model. 50% of women with the highest 5-year risk predictions, identified 94.8% of those with incident breast cancers.CONCLUSION: The modified BOADICEA risk model provided valid risks among a large retrospective cohort of Danish women.

KW - Adult

KW - Aged

KW - Breast Density

KW - Breast Neoplasms/epidemiology

KW - Denmark/epidemiology

KW - Female

KW - Humans

KW - Life Style

KW - Mammography

KW - Middle Aged

KW - Risk Assessment/methods

KW - Risk Factors

KW - Benefit

KW - Registry

KW - Brca1

U2 - 10.1038/s41416-025-03247-3

DO - 10.1038/s41416-025-03247-3

M3 - Article

C2 - 41225192

SN - 0007-0920

VL - 134

SP - 259

EP - 268

JO - British Journal of Cancer

JF - British Journal of Cancer

IS - 2

ER -

Breast cancer risk prediction with a modified BOADICEA model in Danish women

Abstract

Keywords

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