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:

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 History Risk Category

Family Health History

Family Health History

Family Health History

Example

Example

Example

What You Can Do

What You Can Do

What You Can Do

Average: Typically not increased risk, similar to the general population risk

Family History Risk Category

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

Family Health History

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

Example

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

What You Can Do
  • 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

Family History Risk Category

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

One or two first– or second-degree relatives with high grade prostate cancer

Family Health History

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

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

Example

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

What You Can Do

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

Family History Risk Category

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 50 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

  • Two or more first– or second-degreerelatives from the same side of the family with at least one relative with breast cancer and one relative with high-grade prostate cancer or pancreatic cancer at any age.

or

  • Three or more first– or second-degree relatives from the same side of the family with at least one relative with breast cancer and two additional relatives with breast or prostate cancer (any grade) at any age.
Family Health History

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

  • Breast cancer diagnosed at age 50 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

  • Two or more first– or second-degreerelatives from the same side of the family with at least one relative with breast cancer and one relative with high-grade prostate cancer or pancreatic cancer at any age.

or

  • Three or more first– or second-degree relatives from the same side of the family with at least one relative with breast cancer and two additional relatives with breast or prostate cancer (any grade) 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 and paternal grandmother with breast cancer at age 60

Example

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 and paternal grandmother with breast 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

What You Can Do
  • 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 = half sisters, half brothers, 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 1.2023 Genetics/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic.
  2. Final Recommendation Statement: Breast Cancer: Screening. U.S. Preventive Services Task Force. August 2019.

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

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.

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