Using a unique, ethnically diverse cohort of high-risk families, we sought to: examine the significance of founder/recurrent and novel rare BRCA1 and BRCA2 mutations to familial breast and ovarian cancer in the Malays, Chinese and Indian populations of Malaysia; and compare the accuracy of the Manchester Scoring System and the BOADICEA (Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm) risk-prediction models to predict pathogenic mutations and particularly to discriminate at the 10% likelihood level. This evidence concerns the gene BRCA1 and ovarian carcinoma.