How to Calculate Your Breast Cancer Risk

Rona Ahdout3 min readThis piece is part of a series of stories on the breakthroughs reshaping breast cancer screening and prevention to personalize care, detect cancer earlier, and save lives. Read the rest of the stories here. Women are currently recommended to take a breast cancer risk-assessment test starting at age 25. If you haven’t heard about these tests, you’re not alone. As writer Erica Sloan reports here, risk-assessment tests have remained widely underutilized for decades, largely because it wasn’t initially clear who should take them and when. That changed in 2018 when the American College of Radiology (ACR) first recommended all women be formally risk-assessed by their doctor by age 30—which was adjusted to age 25 in 2023—but there hasn’t been an established standard of care around these tests since.Before you DIY one of these free expert-approved* tests online, it’s important to know your family history on both your maternal and paternal sides, as well as your genetic predispositions. These tests aren’t perfect as they often underestimate or overestimate risk. However, Elisa Port, MD, chief of breast surgery at Mount Sinai, notes that if you’re a person who’s nervous about your risk, you can run multiple tests and see what you get.Afterward, you should discuss the results with your primary care doctor or gynecologist. Alternatively, you can ask your doctor if you can run through a test together for a more accurate assessment. Based on the results, your screening plan will be put into place.The Tyrer-Cuzick ModelA favorite among experts, this test estimates your lifetime risk of developing breast cancer using your personal and family health history. It’s not as cumbersome as some of the other models, but it does require you to know an extensive family history for it to be accurate.CALCULATE YOUR RISKThe Gail ModelThis quick test tells you your five-year and lifetime risk. Once considered the gold standard model, this test has been demoted since it doesn’t include extensive family history. It also may underestimate risk in people with strong hereditary cancer syndromes, and you must be at least 35 years old to take it.CALCULATE YOUR RISKBreast Cancer Surveillance Consortium Invasive Breast Cancer Risk CalculatorThis tool for women ages 35 to 79 estimates five- and 10-year risk based on age, race, ethnicity, family history, history of breast biopsy, breast density, body mass index (BMI), menopausal status, and age at first childbirth.CALCULATE YOUR RISKThe Black Women’s Health Study Breast Cancer Risk CalculatorThis newish tool was developed specifically for Black women ages 30 to 70. It asks for medical and reproductive history, as well as family history, to determine a woman’s five-year risk.CALCULATE YOUR RISKBRCAPROThis test predicts the likelihood that you carry a BRCA mutation and whether you should be referred for genetic counseling. It's generally administered by medical professionals since it requires a complex evaluation of family history. It doesn't work well in people who don't have a strong family history.BOADICEABOADICEA predicts your 10-year risk, lifetime risk, and genetic mutation probability by looking at family history, lifestyle factors, reproductive factors, breast density, and polygenic risk scores. It's one of the most comprehensive models around, and is typically administered by clinicians.*Reviewed by Shari Goldfarb, MD, a medical oncologist at Memorial Sloan Kettering Cancer Center, and Elisa Port, MD, chief of breast surgery at Mount Sinai.Photographs: Rona AhdoutVisual Director: Fabienne Le RouxArt Director: Christine Giordano