Risk Assessment

How to measure YOUR risk of breast cancer

Every woman has some risk of breast cancer. In the U.S., 1 in 8 women will be diagnosed with invasive breast cancer over the course of her lifetime. This means the average woman’s breast cancer risk is 12-13%. A man’s lifetime risk, by comparison, is much lower at 1 in 833 — far less than 1%.

Just as there are factors that INCREASE the risk of breast cancer, there are ways to REDUCE your risk.

The starting point can be assessing YOUR PERSONAL RISK of breast cancer. Thankfully, there is a survey tool that can calculate a woman’s risk of developing breast cancer in her lifetime.

There are two breast cancer risk assessment tools that doctors use to calculate a woman’s risk of breast cancer:

  1. Gail personal health questionnaire that women and their doctors answer together. The resulting Gail score estimates the risk of developing invasive breast cancer in the next 5 years.
  2. The Tyrer-Cuzick questionnaire assesses breast cancer risk based on a woman’s answers to questions about age at first period, height, weight, childbearing history, family history of breast cancer, menopausal status, and use of hormone replacement therapy. The calculated score provides the risk of developing invasive breast cancer within 10 years of the current age, as well as over a lifetime. A study published in JAMA Oncology in 2018 found that the Tyrer-Cuzick breast cancer risk assessment tool is a valid tool over the past 20 years.

The Tyrer-Cuzick tool is used by some imaging centers that provide mammograms as additional risk assessment tool. This helps the imaging center and breast specialist develop a screening schedule for the woman based on her risk of developing breast cancer.

With that said, a Mayo Clinic study found the Tyrer-Cuzick tool is less accurate predicting risk of breast cancer for those women with atypical hyperplasia. Women with atypical hyperplasia have a four-fold higher risk of breast cancer. Atypical hyperplasia isn’t cancer, but it increases the risk of breast cancer. Atypical hyperplasia relates to an accumulation of abnormal cells in the milk ducts of the breast. Atypical hyperplasia is diagnosed after a biopsy of a suspicious area found during a clinical breast exam or on an imaging test, such as ultrasound or a mammogram. Consequently, the Tyrer-Cuzick questionnaire is not used for these women.

A woman can answer most of the Tyrer-Cuzick questions herself. The Tyrer-Cuzick tool can be found at this link:


MANAGING your personal risk of breast cancer

If you ARE at high risk of developing breast cancer, the key is early detection. Early detection is key to a successful outcome.

If you know that you have a higher-than-average risk of breast cancer, you and your doctor will develop a risk management and screening plan tailored to your unique situation. General recommended screening guidelines include:

  • a monthly breast self-exam
  • a yearly breast exam by your doctor
  • a digital mammogram every year starting at age 40

Depending upon your risk profile, personal screening plan also may include:

  • breast MRI
  • breast ultrasound

Factors that affect your risk of breast cancer

The following factors can affect your personal risk of breast cancer. Your physician will ask about these factors in helping you gauge your risk.

  • Your age and family history of cancer
  • Your personal history of breast cancer
  • Prior radiation to chest or face
  • Certain breast changes
  • Race/Ethnicity
  • Being overweight
  • If and when you were pregnant and how many children you had
  • Breastfeeding history
  • Menstrual history, starting age and menopause age
  • Using hormone replacements
  • Drinking alcohol
  • Dense breasts
  • Lack of exercise
  • Smoking
  • Exposure to certain chemicals in cosmetics, sunscreen
  • Low vitamin D level

Ways to lower your risk of breast cancer

Some of the risk factors associated with breast cancer risk can’t be changed, such as age, family history and genetics. Here are things you CAN do to lower your risk of breast cancer.

  • maintaining a healthy weight
  • exercising every day
  • limiting or avoiding alcohol
  • eating a healthy diet that’s low in processed foods, sugar, and trans fats
  • not smoking

Assess your risk of breast cancer with the Tyrer-Cuzick Risk Assessment Calculator