Breast cancer risk assessments: What to know
April 24, 2026
Whatever your question, odds are there’s an online resource that promises an answer. That means it’s just as easy to search ‘What should I make for dinner?’ as it is ‘What’s my breast cancer risk?’
As a breast medical oncologist, some of the same tools my team uses to clinically assess breast cancer risk can be accessed for free online. But just like finding any cancer information online, there are some practical considerations to keep in mind.
Ahead, I’ll explain how breast cancer risk assessments work, how UT MD Anderson health care professionals use them and what to know before taking one yourself.
Key takeaways:
- Breast cancer risk assessments estimate a woman’s risk of developing breast cancer over time.
- Each assessment considers a different set of factors, which may include demographics, medical history, family history and gene mutations.
- At UT MD Anderson, health care providers use multiple risk assessment tools to get a more complete look at a patient’s risk.
- No matter your risk level, follow breast cancer screening guidelines.
Each risk assessment considers different factors
Breast cancer risk assessment tools estimate breast cancer risk over time. They are designed to be used by women who have not been diagnosed with breast cancer. There are a variety of breast cancer risk assessments. Each considers different factors. Likewise, the data sources these assessments are modeled on vary.
There is no single best model; each has its pros and cons. That’s why your health care providers may use a combination of models, depending on the focus of the risk assessment. For example, here at UT MD Anderson, health care providers and genetic counselors use a program that includes several models to give each patient the most comprehensive analysis. This is usually a range, rather than one number.
A few of the breast cancer risk assessments you might come across include:
- Breast Cancer Surveillance Consortium 6-Year Advanced Breast Cancer Risk Calculator
- Breast Cancer Surveillance Consortium 5-Year Invasive Breast Cancer Risk Calculator
- Black Women’s Health Study (BWHS) Breast Cancer Risk Calculator
- BOADICEA
- Claus
- The Gail Model
- Tyrer-Cuzick Risk Assessment Calculator
- Options created by hospitals and clinics
Ahead, we will take a closer look at two of the publicly available risk assessments used by UT MD Anderson providers: the Tyrer-Cuzick Risk Assessment Calculator and The Gail Model.
Tyrer-Cuzick Risk Assessment Calculator
This tool estimates a woman’s age-adjusted lifetime breast cancer risk.
It uses the IBIS v8 risk assessment model, which is based on data from women in the United Kingdom and Sweden.
A high risk is considered an age-adjusted lifetime breast cancer risk of 20% or higher.
Tyrer-Cuzick considers:
- History of breast cancer
- Age
- Height
- Weight
- Menstrual history
- Age of first menstrual period
- Reproductive history
- Menopause stage
- Age at menopause
- Use of hormone replacement therapy
- BRCA1 or BRCA2 gene mutations
- Breast biopsy results
- History of ovarian, colorectal, pancreatic or uterine cancer
- Breast density
- Ethnicity
- Family history of breast, ovarian, pancreatic, colorectal or endometrial cancer
- Family history of BRCA genetic testing
The Gail Model
This test, also known as the Breast Cancer Risk Assessment Tool (BCRAT), estimates a woman’s risk of developing invasive breast cancer in the next five years and in her lifetime.
It was developed using data from a study of 280,000 white women ages 35 to 74, along with data from the National Cancer Institute Surveillance, Epidemiology and End Results (SEER) Program.
A high 5-year breast cancer risk for women ages 35 and older is considered 1.7% or higher.
The Gail Model considers:
- History of breast cancer, ductal carcinoma in situ, or lobular carcinoma in situ
- Radiation therapy to the chest to treat Hodgkin lymphoma
- BRCA1 or BRCA2 gene mutations, or other genetic syndromes that increase breast cancer risk
- Age
- Race and ethnicity
- History of breast biopsy
- Age of first menstrual period
- Reproductive history
- First-degree relatives (mother, sisters, daughters) with breast cancer
Pros and cons of risk assessment models
Pros
They can help you better understand breast cancer risk factors
While not all risk assessments consider every breast cancer risk factor, these tests consider many of the most important breast cancer risk factors.
Risk assessment models can help you understand your risk level and make informed decisions together with your care team.
Factors that can influence your breast cancer risk include:
- Sex
- Age
- A germline mutation such as BRCA1, BRCA2, PALB2, CHEK2, CDH1 or PTEN. This is the factor with the highest breast cancer risk.
- A personal history of breast conditions, including atypical ductal hyperplasia, lobular carcinoma in situ and ductal carcinoma in situ (DCIS). These conditions can increase breast cancer risk in the same and opposite breast, even if removed.
- Family history
- Estrogen levels
- Dense breast tissue
Related: How to reduce your breast cancer risk
They can help inform screening and treatment decisions
Risk assessments can help you understand your breast cancer risk. This impacts how your care team will screen you for the disease over time.
That’s why UT MD Anderson recommends that women ages 25 to 30 ask their doctors for a breast cancer risk assessment.
Screening recommendations for women at an average risk for breast cancer depend on age.
If you are:
- Age 25 to 39, get a clinical breast exam every one to three years.
- Age 40 and older, get a mammogram and clinical breast exam every year.
If you are at increased risk for breast cancer, your doctor may recommend you start screenings earlier, get screened more frequently or get additional screenings. Women at a greatly increased risk of breast cancer may also consider risk-reduction strategies, such as preventive therapy, when appropriate.
Cons
They can overestimate or underestimate risk
Risk assessments consider different factors. This means a certain assessment may overestimate or underestimate your risk of breast cancer.
For example, we usually don’t use The Gail Model by itself. It doesn’t consider paternal family history, which means it may underestimate breast cancer risk for a woman with a strong family history of cancer. It also doesn’t consider the age at which a family member was diagnosed with breast cancer, or whether that cancer was in both breasts.
If an assessment underestimates risk, it might give you a false sense of security that allows you to skip your breast cancer screening. But if an assessment overestimates risk, it can cause a lot of anxiety. That’s why risk assessments should be performed by an expert who can help you better understand your risk and what it means for you.
Don't skip screening based on test results
No matter what you score on a breast cancer risk assessment, don’t skip breast cancer screening.
Consider a woman who gets tested for BRCA gene mutations and finds out she doesn’t have the mutations. This doesn’t mean she will never develop breast cancer, but rather her breast cancer risk is the same as the rest of the population. It's still important for her to get breast cancer screenings.
In addition to practicing breast awareness and staying on top of breast cancer screening, focus on healthy habits to reduce your breast cancer risk. This means eating a healthy diet, getting physical activity, avoiding tobacco, limiting alcohol intake and maintaining a healthy body weight.
The bottom line? Risk models are not perfect. Even if you have a low score, there's a chance the assessment didn’t consider another risk factor you may have. Always work with your doctor to determine your breast cancer risk. And remember, even the lowest screening score doesn’t give you a pass to skip your next screening.
Request an appointment at UT MD Anderson online or call 1-877-632-6789.
Risk assessments should be performed by an expert.
Banu Arun, M.D.
Physician