Overview
Breast cancer risk assessment
This information is for women who have already had a family history risk assessment for breast cancer.
It provides advice and screening options to those who have been assessed with a high or moderate risk and for those with a risk about the same as the general population.
Breast cancer is a common disease. In the general population of the UK, about 1 in 7 women will develop breast cancer.
Breast cancer in men is much less common. Around 1 in 100 (less than 1%) of breast cancer cases in the UK are in men.
Some women have an increased chance of developing breast cancer because of their genes (their genetic makeup). Although breast cancer is common, having an inherited tendency to developing breast cancer is quite rare.
Only 5 to 10 out of 100 (5% to 10%) of all breast cancers happen because of an inherited tendency (also called a genetic predisposition).
Risk assessment
Your family assessment will identify your risk of having an inherited tendency to developing breast cancer. There are several things that alter the risk of developing breast cancer.
Increases risk
- The contraceptive pill can slightly increase the risk of breast cancer while you're taking them. The benefits from taking the pill often outweigh this increase. Within a few years of stopping, this slightly increased risk disappears.
- Hormone replacement therapy (HRT) can slightly increase the risk of developing breast cancer. There is no increase in risk if it's taken for less than a year, however, the risk is higher if it's taken for over 5 years. The increased breast cancer risk from taking HRT decreases as soon as you stop taking it. Within 5 years of stopping HRT, the risk is approximately at the same level as if you had never taken it.
- Alcohol increases the risk of breast cancer.
- Being overweight increases the risk of breast cancer for women after the menopause.
Decreases risk
- Pregnancy and breastfeeding lower the risk of breast cancer.
- Regular exercise lowers the risk of breast cancer.
- Eating plenty of fresh fruit and vegetables, and reducing your cholesterol intake, help lower the risk of cancer.
This is known as a ‘near population’ risk. It means that your risk of developing breast cancer is estimated to be about the same as for anyone else in the general population.
Women with a near population risk of developing breast cancer are unlikely to have an inherited tendency to developing breast cancer.
Screening
Breast screening is based on nationally recommended guidelines. These can be found on the National Institute for Health and Care Excellence (NICE) website.
Women aged 50 to 71 are offered a mammogram every 3 years as part of the National Breast Screening Programme.
Women over 71 years old can request that their breast screening continues every 3 years if they wish.
There is a government leaflet called NHS breast screening - helping you decide which explains this.
You do not need a mammogram more often because:
- Breast cancer is easier to see on a mammogram after the menopause.
- If breast cancer does occur, it is likely to grow more slowly in women aged 50 or over.
- Breast tissue in young women can be too dense (tightly packed) for a mammogram to be helpful when there is no increased risk of breast cancer.
If you have a moderate risk of breast cancer, this means that your risk of getting breast cancer is higher than the risk for women with no family history of the disease.
Overall, your lifetime risk of developing breast cancer would be about 1 in 6.
It is more likely that you and your relatives will not develop breast cancer.
Screening
Breast screening is based on nationally recommended guidelines. These can be found on the National Institute for Health and Care Excellence (NICE) website.
Current guidelines recommend that women with a moderate risk of breast cancer have mammograms once a year from 40 to 49 years old.
There is no evidence that screening before the age of 40 is helpful for those with a moderate risk, even if your relatives have had breast cancer before this age.
Women aged 50 to 71 are offered a mammogram every 3 years as part of the National Breast Screening Programme.
Women over 71 years old can request that their breast screening continues every 3 years if they wish.
There is a government leaflet called NHS breast screening - helping you decide which explains this.
You do not need a mammogram more often because:
- Breast cancer is easier to see on a mammogram after the menopause.
- If breast cancer does occur, it is likely to grow more slowly in women aged 50 or over.
- Breast tissue in young women can be too dense (tightly packed) for a mammogram to be helpful when there is no increased risk of breast cancer.
A high risk of breast cancer means that, based on your personal history or your family history, you are estimated to have a higher than average chance of getting breast cancer during your lifetime.
Having a high risk means that your risk of getting breast cancer is higher than in women with no family history of the disease.
Overall, your lifetime risk of developing breast cancer would be about 1 in 3.
Screening
Breast screening is based on nationally recommended guidelines. These can be found on the National Institute for Health and Care Excellence (NICE) website.
Current guidelines recommend that women with a high risk of breast cancer have mammograms once a year from 40 to 59 years old.
Women with an exceptionally high risk of breast cancer may be eligible for breast screening under the age of 40.
For most women with a high risk there is no evidence that screening before the age of 40 is helpful, even if your relatives have had breast cancer before this age.
Women aged 60 to 71 are offered a mammogram every 3 years as part of the National Breast Screening Programme.
Women over 71 years old can request that their breast screening continues every 3 years if they wish.
There is a government leaflet called NHS breast screening - helping you decide which explains this.
You do not need a mammogram more often because:
- Breast cancer is easier to see on a mammogram after the menopause.
- If breast cancer does occur, it is likely to grow more slowly in women aged 50 or over.
- Breast tissue in young women can be too dense (tightly packed) for a mammogram to be helpful when there is no increased risk of breast cancer.
Changes to your family history
Please let us know if your family history of cancer changes, especially breast or ovarian cancer, so we can review if this changes your risk assessment.
All women are encouraged to be breast aware. Contact your GP if you notice any changes in your breasts. Please do not wait until your next mammogram.
Tests for inherited breast cancer in the family
Testing for an inherited tendency is available in some families. This depends on the exact details of your family history and whether the necessary cancer tissue or blood samples are available.
If genetic testing is possible, this usually begins by looking for a gene fault (mutation) in a relative who has breast or ovarian cancer. Genetic testing may still be possible if the relative has died.
Patients may attend a nurse-led family history clinic and then be referred to the genetics clinic to discuss testing. If you are seen in the genetics clinic we will explain the options available. If any testing does go ahead this could alter your risk assessment and screening recommendations.
Women whose risk is about the same as the general population are not eligible for these tests as they are unlikely to have an inherited tendency to developing breast cancer.
Further information
Macmillan Cancer Support - charity offering information, advice and support for anyone affected by any type of cancer.
Phone: 0808 808 0000
Breast Cancer Now - charity offering information, advice and support for anyone affected by breast cancer.
Phone: 0808 800 6000
The NHS website has more information on breast screening including information on what to expect if you are trans or non-binary.
GOV.UK explains more about the national breast screening programme.
Resource number 3009/VER4
Published date: July 2023
Review date: July 2026
