Table 1

The Manchester Scoring System with pathology adjustment9 15 16

Cancer, age at diagnosis BRCA1 BRCA2
FBC, <3065
FBC, 30–3944
FBC, 40–4933
FBC, 50–5922
FBC, >5911
MBC, <6058
MBC, >5955
Ovarian cancer, <6085
Ovarian cancer, >5955
Pancreatic cancer01
Prostate cancer, <6002
Prostate cancer, >5901
Breast cancer path adjustment in index case
Grade 320
Grade 1−20
ER positive−10
ER negative10
Triple negative40
HER2+−60
Ductal carcinoma in situ−20
Lobular−20
Ovarian cancer adjustment – any case in family*
Mucinous germ cell or borderline tumoursNo score, that is, score as 0No score, that is, score as 0
High grade serous <60+20
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).