Objective Risk Classification Scenarios

High risk

2 First-degree relatives with breast cancer, at least 1 of whom had been diagnosed at age ≤50

Combination of 3 or more first-degree relatives or second-degree relatives with breast cancer

Combination of 2 breast cancers and ovarian cancers among first-degree and second-degree relatives

1 First-degree relative with bilateral breast cancer

1 First-degree relative or 1 second-degree relative with both breast cancer and ovarian cancer

Breast cancer history: 1 first-degree male relative or 1 second-degree male relative

Personal history of breast cancer, diagnosed at age ≤50

2 Ovarian cancers among first-degree relatives or second-degree relatives (2 first degree, 2 second degree, or 1 first degree and 1 second degree)

1 First-degree relative and 1 second-degree relative with breast cancer, both diagnosed at age ≤50

2 Second-degree relatives on the paternal side with breast cancer, both diagnosed at age ≤50

Elevated risk

1 First-degree relative with ovarian cancer

2 Second-degree relatives with breast cancer (except 2 paternal, both diagnosed at age ≤50)

Personal history of breast cancer, diagnosed at age >50

2 First-degree relatives with breast cancer, both diagnosed at age >50

1 First-degree relative and 1 second-degree relative with breast cancer, at least 1 relative diagnosed at age >50

1 First-degree relative with breast cancer, diagnosed at age ≤50

^a All women classified at average objective risk had very limited or no family history of breast or ovarian cancer.

^b Breast cancer or ovarian cancer diagnosed at any age if an age group is not specified. All family history scenarios refer to female relatives except for the high-risk scenario of breast cancer among male relatives.

^c Ashkenazi-Jewish women with a personal history of breast cancer at any age of diagnosis were classified as high risk. Ashkenazi-Jewish women having any first-degree or second-degree relative diagnosed with breast cancer or ovarian cancer were also classified as high risk, except for 1 elevated-risk scenario: having 1 second-degree relative diagnosed with breast cancer at age >50.