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Breast Cancer Risk Assessment

Breast cancer is the most commonly diagnosed cancer in women (other than skin cancer). The American Cancer Society reports the breast cancer death rate is declining, probably due to earlier detection and improved treatment. This short assessment will help you determine if you have major risk factors for breast cancer. It is not a complete assessment of all risks. For a complete evaluation of your risks, see your health care provider

African-American Asian Caucasian Hispanic Other
lbs.
Feet Inches
Yes No
Yes No
Yes No
Mother Daughter Sister Aunt (mother’s or father’s sister) Grandmother No family history of breast cancer.
Yes No
Yes No
Yes No

This assessment is not intended to replace the evaluation of a health care professional.

Online Medical Reviewer: Freeborn, Donna, PhD, CNM, FNP
Online Medical Reviewer: MMI board-certified, academically affiliated clinician
Date Last Reviewed: 9/14/2013
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