Table 1

The Manchester Scoring System with pathology adjustment

Cancer, age at diagnosis (years)
 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
Pathology adjustment
 Breast cancer (index case only)
  Grade 3+20
  Grade 200
  Grade 1−20
  ER positive−10
  ER negative+10
  HER2 amplified†−60
  Ductal carcinoma in situ−20
 Ovarian cancer (any case in family‡)
  Mucinous, germ cell or borderline tumours00
  High-grade serous, <60+20
  Adopted (no known status in blood relatives)+2+2
  • Each individual and family characteristic (from one side of the family only) is given a numerical weight and these are added to give a score for each of the two genes, BRCA1 and BRCA2.30 Score ‘Cancer, age at diagnosis’ first and then adjust score based on ‘Pathology adjustment’.

  • *Also score grade in addition to triple-negative.

  • †Also score grade and ER status in addition to HER2 status.

  • ‡Only if the relative is not related to index case through more than one unaffected woman aged >60 years.

  • As an example, a 34 year-old woman diagnosed with ER- HER2 amplified grade 3 invasive ductal carcinoma and a first-degree relative with high-grade endometrioid ovarian cancer diagnosed at 63 years of age would score 4+4+2+1–6+5+5=15 points.

  • ER, oestrogen receptor; FBC, female breast cancer; MBC, male breast cancer.