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.
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 one of the following:
- Ontario Family History Assessment Tool
- Manchester Scoring System
- Referral Screening Tool
- Pedigree Assessment Tool
- FHS-7
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 History Risk Category
Family History Risk Category
Family Health History
Family Health History
Example
Example
What You Can Do
What You Can Do
Average: Typically not increased risk, similar to the general population risk
Average: Typically not increased risk, similar to the general population risk
No first– or second-degree relatives with breast or ovarian cancer
One second-degree female relative with breast cancer (in one breast only) diagnosed after age 50
No first– or second-degree relatives with breast or ovarian cancer
One second-degree female relative with breast cancer (in one breast only) diagnosed after age 50
Grandmother with breast cancer diagnosed at age 75
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
- 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
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
One or two first– or second-degree relatives with high grade prostate 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
One or two first– or second-degree relatives with high grade prostate cancer
Mother with breast cancer diagnosed at age 68 and maternal aunt (mother’s sister) with breast cancer diagnosed at 62
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 (compared with 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 or Ashkenazi or Eastern European Jewish ancestry
Taking action may be of greater benefit for women with a moderate vs. average (compared with 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 or Ashkenazi or Eastern European Jewish 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
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
- Triple negative breast cancer diagnosed at age 60 or younger in women
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, or high grade prostate cancer at any age.
One (or more) first– or second-degree relative(s) with:
- Breast cancer diagnosed at age 45 or younger in women
or
- Triple negative breast cancer diagnosed at age 60 or younger in women
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, 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
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
- 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.
- National Comprehensive Cancer Network. NCCN Guidelines Version 3.2019 Genetics/Familial High-Risk Assessment: Breast and Ovarian.
- Final Recommendation Statement: Breast Cancer: Screening. U.S. Preventive Services Task Force. August 2019.
If you are a woman of Ashkenazi or Eastern European Jewish 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 or Eastern European Jewish ancestry are more likely to have BRCA1 and BRCA2 mutations, regardless of their family health history. This means that women of Ashkenazi or Eastern European Jewish 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 or Eastern European Jewish ancestry.