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BOADICEA (Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm, Antoniou et al., 2004, 2008) is a risk model for familial breast and ovarian cancer. The model can be used to compute BRCA1 and BRCA2 mutation carrier probabilities and age specific risks for breast and ovarian cancer. BOADICEA was developed using complex segregation analysis of breast and ovarian cancer based on a combination of families identified through population based studies of breast cancer, and families with multiple affected individuals who had been screened for BRCA1 and BRCA2 mutations. The latest version of the model was based on 2785 families, of which 537 segregate BRCA1 or BRCA2 mutations. BOADICEA models the simultaneous effects of BRCA1 and BRCA2 mutations and assumes that the residual familial clustering of breast cancer is explained by a polygenic component - that is a large number of genes each of small effect - with a variance that decreases linearly with age. Individuals are assumed to follow calendar period and cohort specific incidence rates for breast and ovarian cancer.
The model is implemented in the pedigree analysis software MENDEL and can be used on families of an arbitrary size and structure. The model can incorporate mutation screening data in any combination of individuals and allows for the effects of reduced sensitivity of the BRCA1 and BRCA2 mutation testing techniques.
The National Instituite for Health and Clinical Excellence (NICE) recommends using BOADICEA in the assessment of breast cancer patients to determine eligibilty for MRI screening (see NICE CG41 Familial breast cancer - Full guideline).
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