What you need to know about the Breast Cancer Risk Assessment Tool

In March 2024, actress Olivia Munn announced on social media that she had been diagnosed with cáncer de mama, crediting a simple online tool—known as a breast cancer risk assessment tool—with leading to her diagnosis. She wrote that she shared in hopes it will help others find comfort, inspiration and support on their own journey” and urged other women to ask their health care providers to calculate their breast cancer risk assessment score.

Since then, National Cancer Institute (NCI) has said that Munn’s outreach “led to a surge in visits to the Breast Cancer Risk Assessment Tool site” and the rate of women taking this formerly little-known test increased 4,000%.

Should you take it? That may depend on a few factors. Here’s what you need to know about breast cancer risk assessment tests.

What is a breast cancer risk assessment tool?

There are two common risk assessment tests available—the NCI’s Breast Cancer Risk Assessment Tool y el Tyrer-Cuzick Risk Assessment Calculator. These tools help health care providers estimate a woman’s risk of developing invasive breast cancer in the next five years and up to age 90 (lifetime risk). You can take the test free of charge.

The questionnaire takes about five minutes to complete, and asks the user to answer questions about age, race/ethnicity, personal and family history of breast cancer, and ages at first menstrual period and pregnancy.

The test referenced throughout the remainder of this blog is referring to the NCI’s Breast Cancer Risk Assessment Tool (BCRAT).

Who should—or shouldn’t —take a breast cancer risk assessment test?

People assigned female at birth who carry the BRCA1 or BRCA2 genetic mutation or who have a history of invasive or in situ breast cancer should not take the test because it cannot accurately estimate risk for these groups. There are alternative tests people in these groups may consider taking.

Any person assigned female at birth who is between the ages of 35-85 can consider taking the test, but it does have limitations. According to the NCI website, its test has been validated for white women, Black/African American women, Hispanic women, and Asian and Pacific Islander women in the United States. But risk may be underestimated in Black women with previous breast biopsies and Hispanic women born outside the United States. Estimates for American Indian/Alaska Native women may be inaccurate as well due to limited data. Further research is needed for these groups.

Breast cancer risk assessment tools are not addressed in any current breast cancer screenings recommendations from the U.S. Preventive Services Task Force (USPSTF), American Cancer Society or the National Comprehensive Cancer Network (NCCN).

What should I do with the results of the test? 

If you take the BCRAT on your own, print the results and take them to your next appointment with your health care provider to discuss. Your provider may want to recalculate your risk and use the information to guide your screening recommendations.

The NCI website advises that, “although a patient’s risk may be accurately estimated, these predictions do not allow one to say precisely which woman will develop breast cancer,” and some women who do not develop breast cancer have higher risk estimates than others who do develop the disease.

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Do the results of the test affect when I should get screened for breast cancer? 

Regardless of your test results, you should still get routine screening for breast cancer.

The Prevent Cancer Foundation encourages people assigned female at birth who are at average risk of breast cancer to talk with a health care provider at least once every three years for risk assessment, risk reduction counseling and a clinical breast exam starting at age 25.

Annual mammograms (2D or 3D) should begin at age 40 for those at average risk. Those at higher risk may need to start screening earlier, so knowing your risk is the first step to early detection. If your BCRAT indicates you are at high risk, your health care provider may recommend you begin screening earlier.

How can I reduce my risk of breast cancer? 

In addition to routine screening, you can lower your risk of breast cancer by not using tobacco in any way (If you do, quit now), exercising at least 30 minutes five days a week, avoiding or limiting alcohol, and maintaining a healthy weight.

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