Table 1.
The Manchester Scoring System with pathology adjustment.
| BRCA1 | BRCA2 | |
|---|---|---|
| Cancer, age at diagnosis | ||
| FBC, <30 | 6 | 5 |
| FBC, 30–39 | 4 | 4 |
| FBC, 40–49 | 3 | 3 |
| FBC, 50–59 | 2 | 2 |
| FBC, >59 | 1 | 1 |
| MBC, <60 | 5 | 8 |
| MBC, >59 | 5 | 5 |
| Ovarian cancer, <60 | 8 | 5 |
| Ovarian cancer, >59 | 5 | 5 |
| Pancreatic cancer | 0 | 1 |
| Prostate cancer, <60 | 0 | 2 |
| Prostate cancer, >59 | 0 | 1 |
| Pathology adjustment | ||
| Breast cancer (index case only) | ||
| Grade 3 | +2 | 0 |
| Grade 2 | 0 | 0 |
| Grade 1 | −2 | 0 |
| ER positive | −1 | 0 |
| ER negative | +1 | 0 |
| Triple-negativea | +4 | 0 |
| HER2 amplifiedb | −6 | 0 |
| Ductal carcinoma in situ | −2 | 0 |
| Lobular | −2 | 0 |
| Ovarian cancer (any case in familyc) | ||
| Mucinous, germ cell or borderline tumours | 0 | 0 |
| High-grade serous, <60 | +2 | 0 |
| Adopted (no known status in blood relatives) | +2 | +2 |
Each individual and family relevant tumour (from one side of the family only) is given a numerical weight and these are summated to provide a score for each of the two genes, BRCA1 and BRCA2 [23]. Score ‘Cancer, age at diagnosis’ first and then adjust score through ‘Pathology adjustment’.
FBC female breast cancer, MBC male breast cancer, ER oestrogen receptor.
aAlso score grade in addition to triple-negative.
bAlso score grade and ER status in addition to HER2 status.
cOnly if the relative is not related to index case through more than one unaffected woman aged > 60 years.