The American Cancer Society National Breast Cancer Roundtable (ACS NBCRT) assembled this digital toolkit to support practices and providers in conducting breast cancer risk assessments. Breast cancer risk assessment helps identify individuals at higher risk for breast cancer to enable personalized screening, prevention, and early detection strategies. This toolkit presents evidence-based breast cancer risk assessment tools and provides guidance for providers on their effective use.
Practice Resources
Key Features of Provider-guided Risk Assessment Tools
The provider-guided comparison highlights key features of clinically validated tools designed for use by health care professionals. It includes information on inputs, such as family history, patient characteristics, and breast cancer risk factors, along with each tool’s scope, time horizon, and target population. The comparison is intended to support informed tool selection based on the goals of your practice and the needs of your patients.
Providers may want to work with internal teams, such as clinical, quality, and IT staff, to evaluate which tool aligns best with their workflows, systems, and patient population. Additional resources, including a readiness self-assessment and EHR integration guide, are available to support planning and implementation.
Key Features of Patient-guided Risk Assessment Tools
The patient-guided comparison highlights tools developed to support individuals in assessing their own breast cancer risk. It provides information on the inputs, risk information, and populations each tool is designed to serve. The resource is intended to help providers understand which tools patients may be using and how they might support communication, education, and next steps in care.
Breast Cancer Risk Program Readiness and Planning Tool
The assessment and planning guide helps practices evaluate their current approach to breast cancer risk assessment or implement a new process. It covers six core domains: organizational alignment, clinical workflow, EHR capacity, staff training, patient communication, and continuous improvement. The tool is intended to support planning by identifying existing strengths and uncovering areas that may need additional resources or attention.
EHR Integration Discussion Guide for Breast Cancer Risk Assessment Tools
The electronic health record (EHR) integration guide outlines key considerations for practices and IT teams working together to embed breast cancer risk assessment tools into clinical workflows. It includes topics such as tool selection, data inputs, documentation, user experience, and evaluation. The guide is intended to support implementation planning and help ensure the selected tool fits both the clinical and technical needs of the practice.
Provider Resources
Breast Cancer Risk Assessment Clinic Workflow
The clinic workflow highlights key decision points to guide breast cancer screening, risk assessment, and referral for genetic counseling. Based on current American Cancer Society (ACS) recommendations, the flowchart is designed to support providers in identifying patients who may benefit from risk assessment tools and in determining next steps based on personal and family history.
ACS Breast Cancer Screening Guidelines
ACS has outlined breast cancer screening guidelines based on a patient’s risk level. See the most recent guidelines.
Breast Cancer Risk Assessment Clinic Checklist
The checklist outlines key steps to guide providers through the breast cancer risk assessment process, from introducing the topic and collecting family history to applying a validated tool and sharing results. Designed to support clinical conversations and documentation, the resource helps ensure consistent, thorough assessment and appropriate follow-up based on each patient’s risk level.
Breast Cancer Risk Assessment Communication Scripts
The communication scripts offer practical language to support conversations about breast cancer risk assessment. Designed for different points in the clinical workflow, each script can be adapted based on the patient’s risk level and context. The resource is intended to help providers deliver clear, empathetic guidance and support shared decision-making.
Breast Cancer Screening Recommendations
American Cancer Society Recommendations for the Early Detection of Breast Cancer
American Cancer Society Guidelines for Breast Screening with MRI as an Adjunct to Mammography
Breast Cancer Screening for Women at Average Risk 2015 Guideline Update From the American Cancer Society
Screening for Breast Cancer USPSTF Recommendation Statement
NCCN Breast Cancer Screening and Diagnosis (Free registration required to access from NCCN homepage.)
Shared Decision-making (SDM) for Breast Cancer Screening
Decision Tool for Women with BRCA 1/BRCA 2 Mutations
Breast Cancer Screening Shared Decision-making Toolkit
Decision Aids that Consider Prognosis
Motivational Interviewing (MI)
The SHARE Approach
Effectiveness of motivational interviewing in enhancing cancer screening uptake amongst average-risk individuals: A systematic review
Screening rarely screened women: time-to-service and 24-month outcomes of tailored interventions
Multilevel Intervention Raises Latina Participation in Mammography Screening: Findings from ¡Fortaleza Latina!
Criteria for Referring to a Genetic Counselor
USPSTF criteria
NCCN Guidelines (Free registration required to access.)
Educating the Patient About Risk Factors and Cancer Prevention
Please see Additional Patient Resources
Community and Patient Resources
Initiative Increasing Awareness Among Latinas
Tu Historia Cuenta is a community-based initiative designed to increase genetic risk awareness and access to breast cancer testing among Spanish-speaking Latinas in California. Led by promotores and delivered in Spanish, the program offers culturally tailored education and family history surveys to help identify individuals at higher risk of hereditary breast cancer. Since 2019, Tu Historia Cuenta has reached nearly 1,800 women through virtual sessions and continues to evolve. The program is now testing a hybrid model that connects community outreach with clinic-based follow-up and support for genetic testing.
About Breast Cancer Risk
ACS Breast Cancer Risk and Prevention
ACS Breast Cancer Factsheet for Patients and Caregivers
ACS Breast Cancer Risk Factsheet
ACS Factores de riesgo del cáncer de seno
CDC: Breast Cancer Risk Factors
Mount Sinai: Understanding Your Breast Cancer Risk
Breast Cancer in Different Populations
African American Breast Cancer Alliance Black Women and Breast Cancer
Susan G. Komen LGBTQ People Factsheet
Susan G. Komen Women With Disabilities and Breast Cancer Factsheet
Genetic Risk
Susan G. Komen Genetic Testing and Breast Cancer: Unlocking Family Secrets Factsheet