Risk check
Should I be checked for a BRCA gene mutation?
Harmful changes in the BRCA1 and BRCA2 genes raise the risk of breast and ovarian cancer and run in families. The US Preventive Services Task Force recommends a short family history check for women whose history suggests it, and genetic counseling if that check is positive.
Your family history
Nothing you enter leaves this page. Relatives means both your mother's and your father's side.
What you will see
Whether your answers point to genetic counseling under the USPSTF advice.
Educational only, not medical advice. A genetic counselor or clinician makes the real assessment.
Source
US Preventive Services Task Force, August 2019 recommendation on risk assessment, genetic counseling and genetic testing for BRCA-related cancer; the 7-Question Family History Screening is Table 5 of that statement.
Validated in
Women with unknown BRCA status, including women treated for a past breast, ovarian, tubal or peritoneal cancer who were never tested.
Limits
It is a referral screen, not a test and not a risk estimate. It does not tell you whether you carry a mutation. General breast cancer risk calculators such as the Gail model are not designed to find BRCA-related risk.
What the USPSTF recommends
| Who | Recommendation | Grade |
|---|---|---|
| Women with a personal or family history of breast, ovarian, tubal or peritoneal cancer, or an ancestry linked to BRCA1/2 mutations | Assess with a brief familial risk tool; if positive, genetic counseling, then genetic testing if counseling shows it is indicated (USPSTF 2019) | B |
| Women whose history and ancestry are not linked to harmful BRCA1/2 mutations | No routine risk assessment, genetic counseling or genetic testing (USPSTF 2019) | D |
About the 7 questions
The USPSTF reviewed several brief tools, including the Ontario Family History Assessment Tool, the Manchester Scoring System, the Referral Screening Tool, the Pedigree Assessment Tool and the 7-Question Family History Screening used here. It found them accurate at identifying women more likely to carry a BRCA1/2 mutation, and found too little evidence to recommend one over another (USPSTF 2019). On the 7-question tool, one yes is enough to start a referral (USPSTF 2019).
The factors these tools look for include breast cancer before age 50, cancer in both breasts, breast and ovarian cancer in the same person, breast cancer in a man, several cases of breast cancer in the family, and Ashkenazi Jewish ancestry (USPSTF 2019). Mutations can come from either your mother's or your father's family (USPSTF 2019).
Why it matters
Harmful BRCA1/2 mutations occur in an estimated 1 in 300 to 500 women and account for 5% to 10% of breast cancers and 15% of ovarian cancers. They raise the risk of breast cancer to 45% to 65% by age 70. The risk of ovarian, fallopian tube or peritoneal cancer rises to 39% with a BRCA1 mutation and 10% to 17% with BRCA2 (USPSTF 2019). The estimated rate of these mutations is 0.2% to 0.3% of women overall and 2.1% of Ashkenazi Jewish women (USPSTF 2019).
What genetic counseling involves
Counseling is done by trained health professionals. It includes a detailed look at the family tree, deciding who should be tested, explaining the benefits and harms of testing, interpreting results and discussing options (USPSTF 2019). BRCA tests are highly sensitive and specific for known mutations (USPSTF 2019). Women with a harmful mutation are generally managed with ways to lower future cancer risk: more intensive screening, risk-reducing medicines, and surgery to remove the breasts or the ovaries and fallopian tubes (USPSTF 2019).
Common questions
I don't know my family history. What then?
Because these tools rely on family history, it is unclear how women with a limited or unknown family history should be assessed (USPSTF 2019). Tell your clinician what you do and do not know.
Why not test everyone?
For women whose history and ancestry are not linked to harmful mutations, the USPSTF concludes with moderate certainty that the harms of risk assessment, testing and risk-reducing treatment outweigh the benefits, so it recommends against them as routine (USPSTF 2019).
Also see the breast cancer screening check, the ovarian cancer screening check, the breast cancer prevention medicine check, the colon cancer screening check and all screening tests by age.
Sources
- US Preventive Services Task Force. Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2019;322(7):652. www.uspreventiveservicestaskforce.org/uspstf/recommendation/brca-related-cancer-risk-assessment-genetic-counseling-and-genetic-testing
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-10-30. Spotted an error? See About.