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Understanding Breast Cancer Risk Calculators and Results

Key takeaways: 

  • Understanding your risk of breast cancer is key to being proactive about getting regular scans.
  • There are three main breast cancer risk calculators that are currently in use: Gail (BCRAT), IBIS, and BRCAPro.
  • Risk reduction measures include lifestyle modification measures and regular breast cancer screenings.

Research shows that a combination of factors affects your risk of developing breast cancer. The two major factors include being a woman and aging.

For most who develop breast cancer, it happens after the age of 50. But some will get breast cancer before middle age and with no major risk factors, while others who are at higher risk may not develop breast cancer at all.

Not all risk factors cast the same weight. Breast cancer risk calculators help assess risks, better understand risk factor modification, as well as improve awareness around breast cancer screening.

What Are the Main Risk Factors for Breast Cancer?

There are two types of established risk factors: those you can change and those you can’t.

Risk Factors for Breast Cancer That You Can Modify

  • Sedentary lifestyle
  • Obesity or being overweight after menopause
  • Taking prescription hormone replacement therapy
  • Alcohol intake

Static Risk Factors for Breast Cancer

  • History of breast cancer
  • History of other types of cancer
  • Family history of breast or ovarian cancer
  • Previous radiation treatments
  • Having taken the prescription drug diethylstilbestrol (DES)
  • Having dense breast tissue
  • Having a previous breast diagnosis, such as atypical hyperplasia or lobular carcinoma in situ 
  • Early puberty
  • Early menarche (first menstrual period before the age of 12)
  • Breast cancer gene mutations

What Are Breast Cancer Risk Calculators?

Breast cancer risk calculator: happy mother and daughter

Knowing your risks isn’t exactly the same as understanding them.

Tools like the three listed below are each based on statistical models that use easy-to-understand questionnaires to gather data, such as self-reported health information. Then, using statistical analysis, they calculate a value that estimates or predicts the incidence of breast cancer. Each tool has specific uses and limitations that are noted.

Before using a breast cancer risk calculator, take the time to gather your family history. Talk to your family members about health conditions that run in your family. Chronic diseases like heart disease, diabetes, cancer, and high blood pressure may offer insight into your own health risks.

A family history of ovarian and breast cancer may increase your risk of developing breast cancer, especially if genetic mutations cause cancer such as the BRCA1 gene and BRCA2 gene. Ask about a family history of breast biopsies, invasive breast cancer, lobular carcinoma, and first-degree relatives with abnormal mammograms. 

1. Breast Cancer Risk Assessment Tool (BCRAT)

BCRAT is based on the Gail Model. It uses self-reported personal history information to estimate breast cancer risk over a specific period of time, such as the five-year risk and the lifetime risk.

Test Limitations

The Gail Model breast cancer risk model has been tested in large populations of non-Hispanic Caucasian women and is thought to provide the most accurate estimates of breast cancer risk in this group.

The Gail Model was also tested using ethnicity data from the Women’s Health Initiative for Asian and Pacific Islander, Black, African American, and Hispanic women.

While the model performed well, they found it may underestimate the risk in Black/African American women who’ve had previous breast biopsies, as well as Hispanic women who were born outside the United States. 

2. IBIS Risk Tool

The IBIS Risk Tool breast cancer risk calculator uses the Tyrer-Cuzick risk model to assess a 10-year risk and the lifetime risk for developing invasive breast cancer.

Test Limitations

IBIS considers other low-penetrance genes’ potential contribution to breast cancer risk. There’s some evidence it may overestimate risks of breast cancer recurrence, except for those with a confirmed family history of BRCA1/BRCA2 gene mutations.

This tool is valid for non-Hispanics, Caucasians, Black people/African Americans, Hispanics, and those with Asian and Pacific Island heritage living in the United States. American Indian/Alaska Native women’s risk estimates will be based on data for non-Hispanic, Caucasian women and therefore may be inaccurate.

3. BRCAPro Breast Cancer Risk Calculator

BRCAPro assesses risks associated with BRCA1 and BRCA2 gene mutations that are known to contribute to the development of invasive breast cancer. BRCAPro risk assessment is currently used in genetic counseling and to aid patients in deciding whether to undergo genetic testing. 

Currently, the United States Preventive Services Task Force (USPSTF) recommend: 

“For women who have family members with breast, ovarian, tubal, or peritoneal cancer or have a personal history of these types of cancer, primary care clinicians may use appropriate brief familial risk assessment tools to determine the need for in-depth genetic counseling.”

Tools that were evaluated by the USPSTF included a “brief version” of the BRCRAPro calculator. 

Breast Cancer Risk Reduction Measures

3 senior women smiling to the camera

Having a family history of breast cancer is one of the most predictive risk factors for getting breast cancer. A family history that includes a first-degree relative (such as a mother, sister, or daughter) having breast cancer raises the risk two-fold. Having two first-degree relatives triples a woman’s risk. 

Ethnicity plays a part too. White women are more likely to develop breast cancer in their lifetime, but black women are more likely to have aggressive or advanced-stage breast cancer. These are static factors that can’t be changed.

Breast cancer risk reduction counts on awareness, preventive measures, and controlling the risk factors that you can modify such as:

  • Maintaining a healthy weight.
  • Getting regular exercise.
  • Avoiding tobacco and alcohol consumption.
  • Discussing the risks versus benefits of hormone replacement therapy (HRT) with your primary care practitioner (PCP) or gynecologist (GYN).

Get Regular Breast Cancer Screening

A 3D mammogram, or digital tomosynthesis, is the most cutting-edge breast cancer screening tool available. It may help in the early detection of breast cancer.

When compared to standard 2D mammograms, 3D mammograms create more images of the breasts and display them in thin layers or sections to spot potential tumors sooner.

3D mammographic screening improves early breast cancer detection rates over conventional mammography. As a result, that means earlier treatment and more treatment options if you do develop breast cancer.

To learn more about mammograms, please check out:

Calculate Your Breast Cancer Risk

Interested in evaluating your risk for developing other types of cancer?

Take our 5-minute quiz designed using the Harvard Cancer Risk Index, which was developed by the Harvard Center for Cancer Prevention. 

More than 100 types of cancer can affect your body. Some cancers are genetic and some are associated with certain choices, behaviors, and habits. Others are tied to environmental exposure. 

Not to worry you, but understanding your risks is key to taking preventative measures. Tell us about your medical and family history, answer a few questions about your lifestyle, and our medical questionnaire can help you understand your risks.