Overview
The National Cancer Institute’s (NCI’s) Breast Cancer Risk Assessment Tool (BCRAT) helps users estimate their risk of developing breast cancer in the next five years through a simple, personalized interface. When the surge in demand caused an unexpected outage, our team quickly expanded the platform’s capabilities, improving access and usability and reducing costs.
The Challenge
In cancer research, making advancements to better public health is the goal. As a part of that effort, NCI’s Division of Cancer Epidemiology and Genetics built BCRAT. This tool makes breast cancer risk assessment accessible to patients and doctors around the world through a simple and easy-to-use interface. By answering a series of personalized medical questions, users can estimate their risk of developing breast cancer in the next five years, as well as over their lifetime.
However, when a tool like BCRAT becomes unavailable, the impact goes beyond inconvenience as it can delay diagnosis and prevention.
In May 2025, BCRAT gained widespread attention after actor Olivia Munn publicly credited it for helping predict her cancer diagnosis. Her viral Instagram post led to an unprecedented surge in traffic. Unfortunately, the tool’s original infrastructure struggled to keep up. The spike in users overwhelmed the system, causing a complete crash and cutting off access when awareness and demand were at an all-time high.
The Solution
As one of the contractors supporting NCI, ESI’s development team manages the operations, maintenance, and ongoing updates for BCRAT, including its website and cloud infrastructure. When the original infrastructure crashed, our team responded immediately, restoring functionality by scaling up the hosted instance to meet the surge in demand. To prevent further outages, we transitioned BCRAT to a serverless architecture. This approach enables automatic scaling of the CPU based on real-time usage. As more people access the tool, the system allocates more power to keep the tool available.
The Results
We quickly restored access to the BCRAT tool, minimizing disruption for users. But our work went beyond immediate recovery. We overhauled the system architecture to enhance performance and scalability. The new infrastructure is easier to manage, more cost-efficient to host, and better equipped to handle surges in demand.
We also implemented streamlined deployment practices and monitoring tools, enabling faster updates and real-time system visibility. As a result, our team is now better positioned to maintain uptime, support a growing global user base, and continue advancing the early detection and prevention of breast cancer.
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