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Genomics

Breast and Ovarian Cancer and Family History Risk Categories

This table provides examples of average, moderate, and strong family health histories of breast and ovarian cancer. This may help you understand if you have an increased risk for these cancers based on your family health history. You can also use the Know:BRCA tool to assess your risk of having a BRCA1 or BRCA2 mutation.

Note: This table does not include all possible family health histories of breast and ovarian cancer. If you have concerns about your family health history of breast or ovarian cancer, please talk to your doctor. Your doctor may assess your risk based on your personal and family health history, using a tool such as Know:BRCA or one of the following:

Results may vary, depending on the tool used, and may differ from the risk categories below, which are based largely on the guidelines from the National Comprehensive Cancer Network.1

 

Family
Health History Risk Category		 Family Health History Example What You Can Do

Average:

Typically not increased risk, similar to the general population risk

 No first- or second-degree relatives with breast or ovarian cancer

or

One second-degree female relative with breast cancer (in one breast only) diagnosed after age 50		 Grandmother with breast cancer diagnosed at age 75
  • Get mammograms and other breast exams as recommended by your doctor (learn more)
  • Keep a healthy weight, exercise regularly, and make other choices to lower your risk (learn more)
  • Discuss any concerns with your health care provider

Genetic counseling and testing for hereditary breast and ovarian cancer is not typically recommended for
this type of family

Moderate:

Somewhat higher than the general population risk, but most women from these types of families will not develop breast or ovarian cancer

 One or two first- degree or two second-degree female relatives  with breast cancer (in one breast only), with both relatives diagnosed after age 50

or

Two first- or second-degree relatives with pancreatic or high grade prostate cancer		 Mother with breast cancer diagnosed at age 68 and maternal aunt (mother’s sister) with breast cancer diagnosed at 62
 

Taking action may be of greater benefit for women with a moderate vs. average risk family history.

  • Get mammograms and other breast exams as recommended by your doctor (learn more), with mammograms possibly starting at an earlier age (between ages 40 and 49) for those women with a parent, sibling, or child with breast cancer2
  • Keep a healthy weight, exercise regularly and make other choices to lower your risk (learn more)
  • Discuss any concerns with your healthcare provider

Genetic counseling and testing for hereditary breast and ovarian cancer is unlikely to be recommended for this type of family, unless the family is of Ashkenazi Jewish or Eastern European ancestry

Strong:

Not all women in these families will develop breast or ovarian cancer, but risk is much higher than that of the general population

One (or more) first- or second-degree relative(s) with:

  • Breast cancer diagnosed at age 45 or younger in women

or

or

  • Primary cancer of both breasts

or

  • Both breast and ovarian cancer in the same relative

or

  • Male breast cancer

or

  • Ovarian cancer

or

  • Two or more first- or second-degree relatives from the same side of the family with breast cancer, if at least one breast cancer was diagnosed before age 50.

or

  • Three or more first- or second-degree relatives from the same side of the family with breast, pancreatic, or high grade prostate cancer at any age.

Sister with breast cancer diagnosed at age 40


Paternal aunt (father’s sister) with breast cancer diagnosed at age 45 and paternal grandmother (father’s mother) with breast cancer diagnosed at age 55


Mother with ovarian cancer


Father with pancreatic cancer at age 55, paternal grandmother with breast cancer at age 60, and brother with high grade prostate cancer at age 60
  • Talk with your healthcare provider about cancer genetic counseling

Genetic counseling and testing for hereditary breast and ovarian cancer is often recommended for this type of family. Learn more

First-degree = parents, brothers, sisters, children

Second-degree = aunts, uncles, nieces, nephews, grandparents, grandchildren

Triple negative cancers are a type of breast cancer that lack estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2.

  1. National Comprehensive Cancer Network. NCCN Guidelines Version 2.2016 Genetics/Familial High-Risk Assessment: Breast and Ovarian.

  2. Final Recommendation Statement: Breast Cancer: Screening. U.S. Preventive Services Task Force. February 2016.

Family Health History, Breast and Ovarian Cancer Risk, and Women of Ashkenazi Jewish or Eastern European ancestry

If you are a woman of Ashkenazi Jewish or Eastern European ancestry and have a moderate family health history of breast and ovarian cancer, you should talk with your health care provider about genetic counseling and testing. Women of Ashkenazi Jewish or Eastern European ancestry are more likely to have BRCA1 and BRCA2 mutations, regardless of their family health history. This means that women of Ashkenazi Jewish or Eastern European ancestry who have a family health history of breast or ovarian cancer are at higher risk than women of other ancestries with similar family health histories. A family health history that would be considered moderate risk for most women might be considered strong risk for women of Ashkenazi Jewish or Eastern European ancestry.

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