What is my breast cancer risk?
Answer a few questions about your age, periods, births, family, and biopsies to estimate your chance of invasive breast cancer in the next 5 years and by age 90 with the Gail model, as the National Cancer Institute's Breast Cancer Risk Assessment Tool computes it. For information only. This is not medical advice or a diagnosis. Do not use it to make treatment decisions without a clinician. No licensed clinician has reviewed this page.
- 5-year risk
- 0.5%
The 5-year risk of invasive breast cancer is 0.5% (1% for an average woman of the same age and race).
- Average 5-year risk, same age and race
- 1%
- Risk to age 90
- 6.4%
- Average risk to age 90, same age and race
- 11.9%
5-year risk: 0.5%. The 5-year risk of invasive breast cancer is 0.5% (1% for an average woman of the same age and race).
This calculator gives general information only. It is not medical advice and does not replace a doctor or other health care provider. Talk with a professional about your results. Terms of use
How to calculate
Estimates a woman’s chance of invasive breast cancer in the next 5 years and by age 90 with the Gail model, as the NCI Breast Cancer Risk Assessment Tool computes it, and the average risk for her age and race.
Example with the default inputs (Past breast cancer, DCIS, LCIS, chest radiation, or a BRCA or other gene change? No, Your age 45, Race or ethnicity White, Age at first period 14 or older, Age at first live birth Under 20, Mother, sisters, or daughters with breast cancer None, Breast biopsies None): The 5-year risk of invasive breast cancer is 0.5% (1% for an average woman of the same age and race).
Method: Gail model: relative risk from age at first period, age at first birth, first-degree relatives, biopsies, and atypical hyperplasia, times race-specific breast cancer rates and (1 − attributable risk), projected year by year with competing mortality.
- For women 35 to 85 with no history of breast cancer, DCIS, LCIS, chest radiation, or a known gene change.
- Rates and coefficients are those of the NCI BCRA R package 2.1.2, which the NCI tool uses.
- Risks are rounded to 1 decimal, halves up.
Worked examples
Each example is checked against the calculator on every build.
- Past breast cancer, DCIS, LCIS, chest radiation, or a BRCA or other gene change? No, Your age 45, Race or ethnicity White, Age at first period 14 or older, Age at first live birth Under 20, Mother, sisters, or daughters with breast cancer None, Breast biopsies None gives 5-year risk 0.5%, Average 5-year risk, same age and race 1%, Risk to age 90 6.4%, Average risk to age 90, same age and race 11.9%.
- Past breast cancer, DCIS, LCIS, chest radiation, or a BRCA or other gene change? No, Your age 40, Race or ethnicity White, Age at first period 12 or 13, Age at first live birth 25 to 29, Mother, sisters, or daughters with breast cancer One, Breast biopsies One, Atypical hyperplasia in a biopsy? No gives 5-year risk 1.7%, Average 5-year risk, same age and race 0.6%, Risk to age 90 22.6%, Average risk to age 90, same age and race 12.4%.
- Past breast cancer, DCIS, LCIS, chest radiation, or a BRCA or other gene change? No, Your age 55, Race or ethnicity Black or African American, Age at first period 7 to 11, Age at first live birth No births, Mother, sisters, or daughters with breast cancer Two or more, Breast biopsies Two or more, Atypical hyperplasia in a biopsy? Yes gives 5-year risk 7.2%, Average 5-year risk, same age and race 1.4%, Risk to age 90 34.7%, Average risk to age 90, same age and race 8.1%.Source: BCRA 2.1.2 port (CARE coefficients, Gail 2007): 7.2133%, 1.4109%, 34.7442%, 8.0655%
- Past breast cancer, DCIS, LCIS, chest radiation, or a BRCA or other gene change? No, Your age 50, Race or ethnicity Hispanic or Latina, born in the US, Age at first period 12 or 13, Age at first live birth 30 or older, Mother, sisters, or daughters with breast cancer One, Breast biopsies None gives 5-year risk 1.7%, Average 5-year risk, same age and race 1.1%, Risk to age 90 12.7%, Average risk to age 90, same age and race 8.9%.Source: BCRA 2.1.2 port (Hispanic, US born, Banegas 2017): 1.6643%, 1.1416%, 12.6504%, 8.8545%
- Past breast cancer, DCIS, LCIS, chest radiation, or a BRCA or other gene change? No, Your age 60, Race or ethnicity Chinese, Age at first period 14 or older, Age at first live birth 20 to 24, Mother, sisters, or daughters with breast cancer Two or more, Breast biopsies One, Atypical hyperplasia in a biopsy? Unknown gives 5-year risk 2.1%, Average 5-year risk, same age and race 0.8%, Risk to age 90 11.5%, Average risk to age 90, same age and race 4.7%.Source: BCRA 2.1.2 port (Asian American, Matsuno 2011): 2.0904%, 0.8268%, 11.4886%, 4.6968%
- Past breast cancer, DCIS, LCIS, chest radiation, or a BRCA or other gene change? No, Your age 70, Race or ethnicity American Indian, Alaska Native, or unknown, Age at first period Unknown, Age at first live birth Unknown, Mother, sisters, or daughters with breast cancer Unknown, Breast biopsies Unknown gives 5-year risk 1.1%, Average 5-year risk, same age and race 2.2%, Risk to age 90 3.3%, Average risk to age 90, same age and race 6.3%.
Medical disclaimer
This calculator is for information and education only. It is not medical advice, and its result is not a diagnosis. Do not use it to start, stop, or change a treatment without a clinician who knows your health history. No licensed clinician has reviewed this page. This site's editors checked the formulas and worked examples against published sources. If you think you have a medical emergency, call your local emergency number.
When this does not apply. The Gail model is for women 35 and older (NCI Breast Cancer Risk Assessment Tool). It does not apply after breast cancer, DCIS, or LCIS, after chest radiation, or with a BRCA1, BRCA2, or other gene change that raises risk; the page gives no answer then. It counts only mother, sisters, and daughters, and it is less certain for groups with less study data.
How the risk is worked out
The page follows the NCI BCRA R package, version 2.1.2, which the NCI tool uses.
1. Risk categories
Each answer becomes a category number:
| Factor | 0 | 1 | 2 | 3 |
|---|---|---|---|---|
| Biopsies (NB) | none or unknown | one | two or more | |
| First period (AM) | 14 or older, or unknown | 12 or 13 | 7 to 11 | |
| First live birth (AF) | under 20, or unknown | 20 to 24 | 25 to 29, or no births | 30 or older |
| Relatives (NR) | none or unknown | one | two or more |
Race-specific groupings, as in the package:
- Black (CARE model): AF = 0 always; AM = 2 counts as 1.
- Hispanic, US born and born outside the US: NB = 2 counts as 1; AF = 2 counts as 1 unless there were no births; AF = 3 counts as 2; NR = 2 counts as 1. US born only: AM = 0 always.
- Asian and Pacific Islander groups: NR = 2 counts as 1.
Atypical hyperplasia multiplier (RH): 1.00 with no biopsy (or unknown biopsies); with a biopsy, 0.93 if no atypical hyperplasia, 1.82 if yes, 1.00 if unknown or left empty.
2. Relative risk
LP1 = NB × β1 + AM × β2 + AF × β3 + NR × β4 + AF × NR × β6 + ln(RH), and LP2 = LP1 + NB × β5.
RR before age 50 = e^LP1; RR from age 50 = e^LP2.
| Group | β1 | β2 | β3 | β4 | β5 | β6 |
|---|---|---|---|---|---|---|
| White, and American Indian, Alaska Native, or unknown | 0.5292641686 | 0.0940103059 | 0.2186262218 | 0.9583027845 | −0.2880424830 | −0.1908113865 |
| Black | 0.1822121131 | 0.2672530336 | 0 | 0.4757242578 | −0.1119411682 | 0 |
| Hispanic, US born | 0.0970783641 | 0 | 0.2318368334 | 0.166685441 | 0 | 0 |
| Hispanic, born outside the US | 0.4798624017 | 0.2593922322 | 0.4669246218 | 0.9076679727 | 0 | 0 |
| Asian and Pacific Islander | 0.55263612260619 | 0.07499257592975 | 0.27638268294593 | 0.79185633720481 | 0 | 0 |
3. Absolute risk
For each year of age a from your age up to (not including) the end age: the 5-year group g = ⌊(a − 20) ÷ 5⌋, h1 = (1 − AR) × RR × λ1[g], h = h1 + λ2[g], and
risk = Σ (h1 ÷ h) × e^(−H) × (1 − e^(−h)), where H is the sum of h over the earlier years.
λ1 is the race-specific breast cancer incidence and λ2 the competing mortality for each 5-year age group from 20 to 85 and over. Both, and 1 − AR (one value before 50 and one from 50), are the vectors in the package file absolute.risk.R: White (SEER 1983 to 1987), Black, Hispanic (US born and born outside the US), American Indian, Alaska Native, or unknown (the White rates), and six Asian and Pacific Islander groups (Chinese, Japanese, Filipino, Native Hawaiian, other Pacific Islander, other Asian). For example, White women: 1 − AR = 0.5788413 at all ages; λ1 at 40 to 44 = 0.001265 and at 45 to 49 = 0.001866; λ2 at 40 to 44 = 0.001307 and at 45 to 49 = 0.002181.
- 5-year risk: from your age to your age + 5 (or 90 if sooner).
- Risk to age 90: from your age to 90.
- Average woman: the same sum with RR = 1 and 1 − AR = 1. For White and for American Indian, Alaska Native, or unknown, it uses the package's average rates (SEER and NCHS, 1992 to 1996); for other groups, the group's own rates.
Each risk is shown as a percent, rounded to 1 decimal place, halves up, read from the decimal value (within 1e-9, relative, of a half counts as the half).
Inputs the calculator accepts
Age 35 to 85 in whole years. With a past breast cancer, DCIS, LCIS, chest radiation, or a known gene change, the page gives no answer.
Worked examples
The expected values come from a line-by-line Python port of the package code (in the progress log for this page), because the package has no printed results.
White, 40, first period at 12 or 13, first birth at 25 to 29, one relative, one biopsy without atypical hyperplasia. NB = 1, AM = 1, AF = 2, NR = 1, RH = 0.93. LP1 = 0.5293 + 0.0940 + 0.4373 + 0.9583 − 0.3816 + ln 0.93 (−0.0726) = 1.5646 (1.56464 from the unrounded terms); RR before 50 = e^1.56464 = 4.78. LP2 = 1.56464 − 0.28804 = 1.27659; RR from 50 = e^1.27659 = 3.58. 5-year risk 1.7% (average 0.6%); to 90: 22.6% (average 12.4%).
White, 45, no risk factors (the page default). RR = 1. 5-year 0.5% (average 1.0%); to 90: 6.4% (average 11.9%). The risk is below average because the model's baseline woman has none of the risk factors.
Black, 55, first period before 12, no births, two relatives, two biopsies with atypical hyperplasia. CARE model: AM = 1, AF = 0, NR = 2, NB = 2, RH = 1.82. 5-year 7.2% (average 1.4%); to 90: 34.7% (average 8.1%).
Hispanic, born in the US, 50, first birth at 30 or older, one relative. 5-year 1.7% (average 1.1%); to 90: 12.7% (average 8.9%).
Chinese, 60, first birth at 20 to 24, two relatives, one biopsy with unknown atypical hyperplasia. NR = 2 counts as 1; RH = 1.00. 5-year 2.1% (average 0.8%); to 90: 11.5% (average 4.7%).
American Indian, Alaska Native, or unknown, 70, every other answer unknown. 5-year 1.1% (average 2.2%); to 90: 3.3% (average 6.3%).
Other questions people ask
What is the Gail model?
The Gail model estimates a woman’s chance of invasive breast cancer over a period of time from a few personal facts. Gail and others built it in 1989 from the Breast Cancer Detection Demonstration Project. The National Cancer Institute (NCI) uses an updated version in its Breast Cancer Risk Assessment Tool, with separate versions for Black (CARE), Hispanic, and Asian and Pacific Islander women.
What does a 5-year risk of 1.5% mean?
Out of 1,000 women with the same answers, about 15 would be expected to develop invasive breast cancer in the next 5 years. The page also shows the risk of an average woman of the same age and race, for comparison.
Who should not use this calculator?
Women who have had breast cancer, DCIS, or LCIS; who had chest radiation (for example for Hodgkin lymphoma); or who carry a gene change such as BRCA1 or BRCA2. The model underestimates risk in these women, so the page gives no answer. It is also not for women under 35.
What if I do not know an answer?
Choose Unknown. The model then counts that factor as the lowest-risk answer, as the NCI tool does, so the result may be too low.
Does the model include breast density or the family history of my father’s side?
No. It counts only mother, sisters, and daughters with breast cancer, and not breast density, other relatives, or age at diagnosis. Other models, which your clinician can use, include more family history.