Am I at Risk of Breast Cancer?

Personal Factors:

Are you over the age of 50?

YesNo

"Please Answer The Above Question"

Did you have a baby before the age of 30?

YesNo

"Please Answer The Above Question"

Did you breastfeed for more than 6 months?

YesNo

"Please Answer The Above Question"

Did you have your first period before age 12?

YesNo

"Please Answer The Above Question"

Did you have a late menopause? (after 55)

YesNo

"Please Answer The Above Question"

Have you ever been on hormone replacement therapy?

YesNo

"Please Answer The Above Question"

Lifestyle Factors:

Are you overweight (BMI>25)?

YesNo

"Please Answer The Above Question"

Do you exercise regularly (for more than 30 mins 5 times/week)?

YesNo

"Please Answer The Above Question"

Do you drink more than 2 alcoholic drinks a day?

YesNo

"Please Answer The Above Question"

Personal Breast History:

Have you had previous radiotherapy to the chest area?

YesNo

"Please Answer The Above Question"

Have you previously been diagnosed with Atypical ductal hyperplasia?

YesNo

"Please Answer The Above Question"

Have you previously been diagnosed with Ductal Carcinoma in situ?

YesNo

"Please Answer The Above Question"

Have you previously been diagnosed with Lobular Carcinoma in situ?

YesNo

"Please Answer The Above Question"

Have you previously had breast cancer?

YesNo

"Please Answer The Above Question"

Did your mammogram reveal dense breasts?

YesNo

"Please Answer The Above Question"

Family History:

Do you have 3 or more first or second degree relatives diagnosed with breast cancer?

YesNo

"Please Answer The Above Question"

Do you have a first degree relative who has been diagnosed with ovarian cancer?

YesNo

"Please Answer The Above Question"

Are you of Ashkenazi Jewish descent?

YesNo

"Please Answer The Above Question"

Are you or any close family members positive for BRCA 1 or 2 mutation?

YesNo

"Please Answer The Above Question"

  • University of Cape Town
  • King Edward VII's Hospital
  • Royal Australasian College of Surgeons
  • Royal Hospital for Women
  • prime wales hospital
  • BreastScreen Australia