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Educational checklist for common breast cancer risk factors: age, first-degree family history, atypical hyperplasia or LCIS, reproductive timing, BRCA status, and prior breast cancer. Outputs a weighted score and plain-language tier—not 5-year or lifetime percent risk. For formal estimates, use the NCI Breast Cancer Risk Assessment Tool (Gail) with your clinician.
Last updated: June 4, 2026
Sex
Current age band
First-degree relatives with breast cancer (mother, sister, daughter)
Ever told you had atypical ductal hyperplasia, atypical lobular hyperplasia, or LCIS on a breast biopsy?
Age at first menstrual period
First full-term pregnancy
BRCA1 or BRCA2 genetic test result (if tested)
History of invasive breast cancer or DCIS
Checklist points (female model): 2
Fewer major checklist factors in this model
Your answers do not add many of the historical factors this educational checklist weights heavily. Average population risk still exists; screening recommendations depend on age and country-specific guidelines.
Continue age-appropriate screening discussions with your clinician. Report new breast symptoms promptly.
Important limitations
This is not the NCI Breast Cancer Risk Assessment Tool (Gail), IBIS, or Tyrer-Cuzick. It does not output 5-year or lifetime absolute risk. Dense breasts, alcohol, weight, exercise, and many genes are not scored here. For formal risk numbers, use validated tools with professional interpretation.
Default: 50–59, no family history
2 pts
Fewer major checklist factors in this model
Two first-degree relatives, 50–59
6 pts
Moderately elevated band
One relative + late/nulliparous, 50–59
6 pts
Some elevated-risk factors on this checklist
60+, 2 relatives, atypia, early menarche
14 pts
Strongly elevated band
Pathogenic BRCA: separate pathway — "Pathogenic BRCA1/2 variant — high-risk pathway" (no point score)
| Factor | Points |
|---|---|
| Age under 40 | 0 |
| Age 40–49 | +1 |
| Age 50–59 | +2 |
| Age 60 or older | +3 |
| One first-degree relative with breast cancer | +2 |
| Two or more first-degree relatives | +4 |
| ADH, ALH, or LCIS on biopsy | +4 |
| Menarche before age 12 | +1 |
| No full-term pregnancy or first birth at 30+ | +2 |
| Points | Tier label | Teaching note |
|---|---|---|
| 0–3 | Fewer major checklist factors | Still follow age-appropriate screening; population risk is not zero |
| 4–6 | Some elevated-risk factors | Good time for formal risk models and genetics discussion |
| 7+ | Multiple strong factors | Prioritize clinician or breast specialist; enhanced screening may apply |
| Feature | NCI Gail / BCRAT | This checklist |
|---|---|---|
| Output | 5-year and lifetime absolute % risk (eligible women) | Weighted point score and plain-language tier only |
| Inputs | Age, race/ethnicity, biopsy count, atypia, family history, menarche, parity | Similar themes; no race/ethnicity; simplified bands |
| BRCA / prior cancer | Not designed for known pathogenic variants or personal history | Separate pathways—does not score those through points |
| Breast density | Not included in classic Gail | Not included—discuss with clinician |
| Best use | Validated estimates with stated limitations at bcrisktool.cancer.gov | Education and triage before you use formal tools |
| Topic | Note |
|---|---|
| Average-risk mammography (U.S. overview) | USPSTF: biennial mammography ages 40–74 (2024 update). ACS offers optional annual from 40. Shared decision-making at 40–44 is common. |
| Higher-than-average risk | Earlier start, annual imaging, or breast MRI may be considered with genetics, strong family history, or prior chest radiation—individualized. |
| Symptoms trump screening | New lump, skin dimpling, nipple discharge, or persistent focal pain → prompt clinical exam regardless of checklist score. |
Points: age 50–59 (+2) + two relatives (+4) = 6
Tier: Some elevated-risk factors on this checklist
A good time to review screening intensity and timing with a clinician. Ask whether formal risk models (for example NCI BCRAT / Tyrer-Cuzick where available) or genetics referral are appropriate.
Compare with NCI BCRAT, which might estimate roughly 20%+ lifetime risk in some profiles—only a validated tool + clinician can quote your personal percent.
Points: 3 + 4 + 4 + 1 + 2 = 14 → strongly elevated band
Real-world care may include annual MRI + mammography (if guideline criteria met), chemoprevention discussion, and genetic testing—this checklist only flags that the conversation is urgent.
Education only. Not the Gail model, Tyrer-Cuzick, or a diagnosis. New breast symptoms, pathogenic variants, and personal cancer history require licensed medical care—not a web checklist.
For health education—always note it is not percent risk or medical advice
Suggested hashtags: #BreastCancer #Screening #BRCA #Health #Calculator