Ask the Expert - What is a breast cancer risk assessment?

Professor Gordon Wishart, Check4Cancer’s Chief Medical Officer answers questions on MyBreastRisk, a breast cancer risk assessment which is done on a DNA saliva test for women aged 30+ which determines a woman’s personal lifetime breast cancer risk.  

Q: What is MyBreastRisk?

MyBreastRisk was the first commercially available test to combine genetic, family history and lifestyle factors to determine a woman's personal lifetime breast cancer risk.  You can discover your personal breast cancer risk by using an at-home saliva DNA test, which is also combined with an internationally validated family history and lifestyle questionnaire.

Q: Why should I use MyBreastRisk?

In humans, 99.9% of the building blocks that make up our DNA are the same, but a SNP (single nucleotide polymorphism, pronounced SNIP) is a single building block that is altered and kept through heredity. It is these SNPs that give us our unique appearance and make us different from each other, but they can also be linked to an increased risk of certain diseases such as breast cancer. Unlike the well-publicised breast cancer genes, BRCA1 and BRCA2, which are incredibly rare in the population but confer a massive lifetime breast cancer risk of up to 60-90% if present, SNPs are much more common in the population and each SNP confers a small increased breast cancer risk. We now know of at least 77 SNPs that increase breast cancer risk and the more you have, the higher the risk.

Q: How does the MyBreastRisk DNA test work?

Analysis of all 77 SNPs can now be performed on a saliva DNA sample, the result of which when combined with a lifestyle and family history questionnaire provides a risk score, that can stratify women into different levels of breast cancer risk (‘Average’, ‘Moderate’ or ‘High Risk’). The risk score allows women at higher lifetime risk of breast cancer to start breast screening at an earlier age, and have more frequent screening, whilst women at lower risk require less screening. There is good scientific evidence to show that this risk-stratified type of breast screening is more effective.

Q: How does the risk assessment questionnaire work?

The breast risk assessment questionnaire is completed online and is based on the validated Tyrer-Cuzick model. The Tyrer-Cuzick model is used to estimate the likelihood of a woman developing breast cancer over the course of her lifetime.

If you do not know your medical family history, then the simple saliva DNA test provides an excellent alternative way to discover your breast cancer risk.

Q: Is MyBreastRisk suitable for all women?

As MyBreastRisk is a breast cancer risk assessment, it is not suitable for women who have already been diagnosed with breast cancer, including women with triple-negative or bilateral breast cancer, and those diagnosed under age 45*.

Women with one or more of the following may benefit from a genetic counselling appointment rather than undergo MyBreastRisk:

  • Several relatives with breast cancer
  • Relatives with ovarian, prostate, pancreatic cancer or male breast cancer
  • Jewish ancestry

Find out more about Check4Cancer’s cancer genetic testing services.

* Breast SNP tests are based on a cohort of Caucasian European patients.  Published data in August 2021 has confirmed breast SNP tests should not be used to predict risk in women of other ethnicities.  Check4Cancer therefore only recommends our SNP test for Caucasian European ethnicities.

Q: If I decide to use MyBreastRisk, what can I expect from my test results?

Results are available within eight weeks of when your sample is sent off to our laboratory and your results from the SNP DNA test and the questionnaire are combined to give you an accurate ‘Lifetime Risk Score’.

The ‘Lifetime Risk Score’ has three risk categories which are ‘Average’, ‘Moderate’ or ‘High Risk’, and depending on your test results you will be advised which category you would fall in for developing breast cancer.  Each category is given very clear guidelines on future screening recommendations.

Anyone considered to be within the 'High Risk' group will be offered a free genetic counselling session with Check4Cancer to discuss specific risk reduction strategies or further genetic testing.

Q: Will taking the MyBreastRisk test stop me from getting breast cancer?

Although MyBreastRisk will not prevent breast cancer, it can help you to determine your risk and ensure you are having the most appropriate screening. Those women in the 'Moderate' or 'High Risk' groups can access NHS services to discuss strategies to reduce their risk. You will be empowered to take control of your own breast cancer risk and will be able to make lifestyle choices and behaviour changes that will help you in the future.

Read more about the signs and symptoms of breast cancer and the MyBreastRisk test.

Professor Gordon Wishart | Chief Medical Officer 

Professor Gordon Wishart is the founder, Chief Medical Officer and CEO of Check4Cancer, a leading early cancer detection and cancer prevention company. In 2016 Check4Cancer launched rapid access, streamlined and audited diagnostic pathways for breast and skin cancer to the insured and self-pay markets, leading to the award of “Diagnostic Provider of the Year” at the annual Health Investor Awards in 2018. In late 2017, Check4Cancer launched the first worldwide breast cancer risk test (MyBreastRisk) to combine genetic, family history and lifestyle risk factors to underpin a risk-stratified breast screening programme. As the former Director of the Cambridge Breast Unit from 2005-2010, and current Professor of Cancer Surgery at Anglia Ruskin School of Medicine since 2008, he has a strong track record in clinical research and modernisation of cancer diagnosis and treatment, with more than 100 peer-reviewed papers in scientific journals. In 2010 he led a team of clinicians and scientists that developed the PREDICT breast cancer treatment and survival model, now used worldwide.