The Manchester Scoring System with pathology adjustment9 15 16
| Cancer, age at diagnosis | BRCA1 | BRCA2 |
| FBC, <30 | 6 | 5 |
| FBC, 30–39 | 4 | 4 |
| FBC, 40–49 | 3 | 3 |
| FBC, 50–59 | 2 | 2 |
| FBC, >59 | 1 | 1 |
| MBC, <60 | 5 | 8 |
| MBC, >59 | 5 | 5 |
| Ovarian cancer, <60 | 8 | 5 |
| Ovarian cancer, >59 | 5 | 5 |
| Pancreatic cancer | 0 | 1 |
| Prostate cancer, <60 | 0 | 2 |
| Prostate cancer, >59 | 0 | 1 |
| Breast cancer path adjustment in index case | ||
| Grade 3 | 2 | 0 |
| Grade 1 | −2 | 0 |
| ER positive | −1 | 0 |
| ER negative | 1 | 0 |
| Triple negative | 4 | 0 |
| HER2+ | −6 | 0 |
| Ductal carcinoma in situ | −2 | 0 |
| Lobular | −2 | 0 |
| Ovarian cancer adjustment – any case in family* | ||
| Mucinous germ cell or borderline tumours | No score, that is, score as 0 | No score, that is, score as 0 |
| High grade serous <60 | +2 | 0 |
| Adopted no known status in blood relatives | +2 | +2 |
*As long as not related to index case through more than one unaffected woman aged >60 years.
FBC, female breast cancer; MBC, male breast cancer.
Changes from the previous system:
Grade 3 ER score 3 (6, +2, +1)
Grade 2 ER+ score 7 (6, +0, 1)
Grade 1 ER+ score 9 (6, 2, 1)
1. HER2+ moves from 4 to 6; should in addition include grade and ER score.
2. Score grade in addition to triple negative, that is, grade.
3. Triple negative =+6 3. Add +2 for high-grade serous ovarian cancer <60, that is, sporadic tumour <60 now scores 15 points (8, +5, +2).