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Hello:
Thank you for participating in the pilot study which involves doing a risk assessment for breast cancer, using an international tool (6 risk-rated questions)
 
 
 
What is your age?
   
 
 
 
Have you had previous breast cancer?
 
Yes
 
No
 
 
 
Age at time of 1st menstrual period?
 
Unknown
 
7-11
 
12-13
 
>=14
 
 
 
Age of first live birth?
 
Unknown
 
No births
 
<20
 
20-24
 
25-29
 
>=30
 
 
 
Number of 1st degree relatives with breast cancer? (mom, sister,daughter)
 
Unknown
 
0
 
1
 
>1
 
 
 
Have you ever had a breast biopsy?
 
Yes
 
No
 
 
 
If yes, how many breast biopsies have you had?
 
1
 
>1
 
Not applicable
 
 
 
Have you ever had a breast biopsy that found atypical hyperplasia (abnormal cells)?
 
Unknown
 
No
 
Yes
 
not applicable
 
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