What To Know About Breast Cancer Risk Calculators
Breast cancer risk calculators, or risk assessment models, are tools that healthcare providers use to estimate a person’s risk of developing breast cancer. Many of these tools are freely available online. If you have internet access and can answer a few questions, you can get a sense of your risk of breast cancer in a matter of minutes.
While risk calculators are a starting place to check your risk, they can’t say whether you will or will not be diagnosed with breast cancer.
How do breast cancer risk calculators work?
Before using a breast cancer risk calculator with your healthcare provider or by yourself, you should collect information about your personal and family health history. This will help you answer questions about breast cancer risk factors, such as:
age
family history of breast cancer
race/ethnicity
breast density (from a recent mammogram report)
previous breast biopsy results
hormone exposure (for example, hormones taken for menopausal symptoms)
age at first period
age when periods stopped
childbirth history
weight and height
Most models compare your answers with the answers of others who have also taken the test, then the model calculates a percent risk. This percentage is your risk of developing breast cancer over a defined period of time.
A new breast cancer risk assessment tool that relies only on screening mammograms was recently approved by the U.S. Food and Drug Administration (FDA). The program, called Clairity Breast, uses artificial intelligence to predict five-year breast cancer risk from a routine screening mammogram by detecting subtle features in the mammogram that correlate with future risk.
The average risk of a woman in the U.S. developing breast cancer over her lifetime is 13% (this percentage represents the 1 in every 8 women in the country who will develop breast cancer). A person is considered to be at high risk of breast cancer if their lifetime risk is 20% (1 in 5 risk) or greater. Most risk calculators show if you are low, average, intermediate, or high risk compared to someone your age, race, and ethnicity.
The pros and cons of risk calculators
There are risk calculators that estimate a person’s risk of invasive breast cancer and calculators that estimate a person’s risk of a genetic mutation that increases risk of breast cancer such as BRCA1 or BRCA2.
“The biggest benefit of using breast cancer risk calculators is that they're objective,” says Jennifer Plichta, MD, the director of the Breast Risk Assessment Clinic in the Duke Cancer Institute. “There are times when somebody comes in, and I think, ‘Oh, wow, she's definitely gonna be high risk,’ and the number says she probably isn’t.” Risk calculators can help cut through such assumptions.
Dr. Plichta encourages people to use the breast cancer risk calculators available online, but to then take the results to a provider who understands their limitations and can advise you on what the findings might mean.
One limitation is that risk calculators that calculate lifetime risk tend to overestimate the risk in young women and underestimate the risk in older women.
Another limitation is that most models were developed based on people who are primarily of European ancestry, says Dr. Plichta. If your ancestral background isn’t primarily European, a certain model may inaccurately calculate your risk. While some models have been updated to include more diverse racial and ethnic categories, many still lack data from other populations.
Additionally, risk calculators are based on research from cisgender people (those whose internal sense of gender corresponds with their sex assigned at birth) and have not been tested on transgender individuals. This means that if you are transgender or gender non-conforming, these tools may not accurately calculate your risk.
Lastly, risk calculators are designed to predict the risk of breast cancer in women who have never had breast cancer. They aren’t able to predict a second breast cancer in women who have previously been diagnosed with breast cancer.
According to Dr. Plichta, any healthcare provider with appropriate training or expertise can conduct risk assessments. This usually includes physicians, physician assistants, and nurses with advanced training.
“If a provider does not feel comfortable having these discussions, there are often local breast clinics that would be open to see you and have the discussion,” Dr. Plichta says.
What are the most common breast cancer risk calculators?
Most breast cancer risk calculators are available online and take a few minutes to complete. Each has certain advantages and limitations, and many providers prefer to use a certain one, or a combination of a few.
“As long as you and your provider understand what the limitations of the model are, and how they were developed, I think any of them are fine to use,” says Dr. Plichta.
The National Cancer Institute’s Breast Cancer Risk Assessment Tool (BCRAT), or Gail model, is one of the most popular among providers. The model predicts your risk of developing invasive breast cancer within five years and up to age 90. Originally developed in 1989 based on U.S. women undergoing mammograms, the Gail model has been updated several times to include more data from diverse racial and ethnic backgrounds. The Gail model does not take breast density into account.
The tool has been tested to ensure its accuracy for cisgender women who are white, Black/African American, Hispanic, Asian, and Pacific Islander in the United States. The tool may underestimate risk in Black people with previous biopsies and Hispanic people born outside the United States. It may also be less accurate at calculating risk for American Indian and Alaskan Native people.
The BCSC has two risk calculators. These calculators were developed using data collected from women undergoing screening mammograms across the United States. The race and ethnicity of these women reflects the U.S. population (including white, Black/African American, Hispanic, Asian, Native American/Alaska Native, and Native Hawaiian/Pacific Islanders).
The first BCSC calculator predicts the risk of developing invasive breast cancer within five and 10 years. A new BCSC model estimates the risk of advanced breast cancer within the next six years.
Your provider may use the BCSC invasive breast cancer results to discuss ways to prevent breast cancer and the BCSC advanced cancer results to discuss how often you need breast cancer screenings.
The BWHS breast cancer risk calculator predicts the risk of developing invasive breast cancer within the next five years as well as over the lifetime for Black women in the United States. The calculator was developed and tested using data from several large studies of breast cancer in Black women in the U.S.
The IBIS, or Tyrer-Cuzick model, predicts the likelihood of developing cancer within 10 years, as well as over your lifetime. The model was developed in white women in the United Kingdom.
Plichta says she prefers to use the Tyrer-Cuzick model because it asks users about the most risk factors to predict breast cancer risk compared with the other models.
Jean Bao, MD, a breast surgical oncologist at Stanford Medicine, uses both the Gail and Tyrer-Cuzick model. “When someone has an extensive family history [of cancer], I tend to use the Tyrer-Cuzick, because the Gail model only looks at first-degree relatives,” she says.
Your healthcare provider may use results of the Tyrer-Cuzick model to determine whether you should receive genetic testing.
The tool has also been shown to overestimate risk in women who are young, Hispanic, and Black.
The BOADICEA model (also called CanRisk) calculates your risk for breast cancer and ovarian cancer. This tool relies mostly on family history and genetic information.
The results can help you make decisions about genetic testing and increased screening.
BRCAPRO predicts your risk of having a genetic mutation of the BRCA1 and BRCA2 genes. The prediction is based on your family’s history of breast or ovarian cancer.
BRCAPRO results may help you and your provider decide whether genetic testing might be a good idea for you.
I have a high risk score. Now what?
If your score on a risk calculator suggests you are at high risk of breast cancer, you should discuss your risk score with your healthcare provider.
When Plictha calculates breast cancer risk for her patients and it returns a “high-risk” score (lifetime risk of 20% and above), she said that she focuses on the general degree of their risk (for instance, whether a person is close to 20% risk versus 45% or higher).
Women identified as being at higher-than-average risk of breast cancer may benefit from earlier breast cancer screenings. However, Dr. Plichta notes the additional annual screenings and follow-ups recommended for people identified as high risk can be overwhelming.
“For these patients, I often remind them that we do not need to make an imaging plan for life, which can feel overwhelming by itself, but rather, we just need to decide what imaging we want to do in the next 12 months,” Dr. Plichta said. “We can deal with next year's imaging when we see them next year.”
— Last updated on July 18, 2025 at 1:33 PM