Hereditary Breast & Ovarian Cancer Program

Risk Stratification

The purpose of genetic risk assessment is to identify individuals with a greater than average genetic contribution to disease, who may benefit from additional screening and preventive interventions. Using clues from the personal and family history, you can classify an individual as average (general population), moderate, or high risk. Use with: Red Flags Checklist Tool.

Risk Level Family History EvidenceBreast Cancer

Lifetime Risk (<70 yrs)

Average No genetic red flags No more than one second-degree^ relative with

breast cancer onset at typical age

~8-12 %

Moderate No genetic red flags One first-degree^ or two second-degree relatives

with breast cancer onset at typical age~15 - 25%

High

One or more genetic red flags One or more female first or second-degree

relatives with breast cancer younger than 50, or ovarian or male breast cancer at any age

>40%

*Genetic red flags for HBOC include early age of onset, bilateral disease/multiple primaries, male breast cancer, ovarian cancer, multiple affected relatives, disease despite preventive measures, Ashkenazi Jewish ancestry, and other notable history (e.g., unusual physical features, intellectual disability, birth defects)

^ First-degree relatives are parents, children, or siblings. Second-degree relatives are grandparents, grandchildren, uncles & aunts.

In addition to family history, personal history risk factors can increase an individual’s risk of developing cancer. For example, behavioral or lifestyle choices (e.g., cigarette use, alcohol consumption) can affect cancer risk generally; reproductive history can affect a woman’s breast cancer risk (e.g., age at menarche).

Adapted from Schneider K. (2011). Counseling about cancer: strategies for genetic counseling. New York: Wiley-Liss.

Published September 2013 © NCHPEG All rights reserved