The risk calculator can determine the possibility of developing breast cancer within 10 years of your current age and lifetime. The purpose of this tool is to help you become informed and assist in how you should proceed for genetic counseling and testing.
Q1. What is the Tyrer-Cuzick model and how is it used for breast cancer risk assessment?
The Tyrer Cuizck model, sometimes referred to as IBIS tool, provides a risk score that estimates the likelihood of a woman developing breast cancer in 10 years and over the course of her lifetime. The risk score is calculated using a variety of risk factors that include personal health history, as well as family history of cancers. The score is typically expressed as a percentage.
Q2. What are the risk factors used to calculate the Tyrer Cuzick score?
The major risk factors are:
- Age at menarche
- Age at first delivery
- Age at menopause
- Breast density
- Ashkenazi Jewish heritage
- History of hormone use
- Genetic testing results for BRCA 1 and BRCA 2
- Number of daughters
- Number of sisters & half sisters
- Number of maternal aunts
- Number of paternal aunts
- Atypical breast biopsies, ie: ADH, ALH, LCIS
- History of breast biopsy/surgery
- Personal or family history of Breast cancer
- Age cancer was diagnosed
- Cancer in one breast or both breasts
Q3. What does it mean to have dense breast tissue, and why does it matter for my Tyrer Cuzick risk score?
Breast cancer research and advances in risk assessment have shown that having dense breasts is a contributing factor in determining a woman’s risk of breast cancer. Dense breast tissue refers to the appearance of breast tissue on a mammogram and the makeup of supportive and fatty tissue in the breast. The more fatty tissue, the less dense the breast is. Dense breast are common and can be caused by simply being younger, having a lower body mass index, or taking hormone therapy for menopause; researchers are still studying why some women have dense breast and other do not. Non-dense tissue appears dark and transparent, whereas dense breast tissue appears as solid white area on a mammogram; the solid white area can make it hard for radiologists to accurately analyze the image with a mammogram, so your provider may recommend supplemental imaging, like a breast ultrasound or other recommendations, to ensure no cancers are missed. Having dense breast alone is not cause for concern, and you should speak with your doctor about your breast density and how it affects your risk status.
Q4. Why is it important for me to know my risk score?
Risk assessment can help breast centers tailor screening and follow up recommendations to ensure you are receiving the care you need. Risk assessment identifies women who are candidates for additional imaging, genetic counseling, genetic testing, and/or other specialized recommendations.
Q5. What is considered a high risk score for Tyrer Cuzick?
Some facilities may have different guidelines, so you should check with your imaging provider, but generally:
- Less than 15% is considered average risk
- Between 15-19% is considered intermediate risk
- Greater than 20% is considered high risk
Q6. Are there other risk models like Tyrer Cuzick?
Yes, there are other risk models such as Gail/NCI, BRCAPRO, Claus, BCSC and more; however, Tyrer Cuzick has been widely accepted as the most comprehensive risk model due to the more detailed data collection. Your facility may use one or more of the models together.
Q7. How can I have my risk score calculated?
While risk calculators and other tools exist online, it is best to speak with you doctor about having your risk score calculated. Learning you are high risk from an online calculator without guidance from your doctor may only cause unnecessary anxiety.
Q8. I am in the high risk category – does this mean I will definitely develop breast cancer?
No, being high risk just means that when statistically compared to other women, your chances are higher, sometimes only slightly higher. It is completely understandable to be concerned about your high risk status, but early detection is our best tool against breast cancer. By identifying your risk, your doctors can provide you with a personalized screening plan and/or risk reduction options.
Q9. I am in the high risk category – Is there anything I can do to reduce my risk of being diagnosed with breast cancer?
You should speak with your doctor about your specific circumstances to determine if there is anything you can do to lower your risk. In some cases, your doctor may recommend lifestyle changes, and in higher risk cases, there are risk lowering drugs and interventional surgery options. It is important, however, that your doctor make the appropriate recommendations.
Q10. I have already been diagnosed with breast cancer. Does risk assessment apply to me?
No, risk assessment does not apply to those over the age of 85 and those already diagnosed with breast cancer.
Q11. Are there any additional resources online to learn more about breast cancer risk assessment?
While your doctor and imaging providers are the best resources, here are a few sites that can provide you with more information until you speak to your doctors: