Breast Cancer Risk Assessment

Breast Health Assessment

Breast cancer is the most commonly diagnosed cancer in women other than skin cancer.
The American Cancer Society says the breast cancer death rate is declining. This is
probably because of earlier detection through routine screening and better treatment.
Early detection is the main way to find breast cancer when it’s small and easier to
treat.

This short assessment will help you learn if you have risk factors that may raise
your breast cancer risk. It is not a complete review of all breast cancer risks. For
a complete evaluation of your risks, see your healthcare provider. Knowing your breast
cancer risk is helpful when making a breast cancer screening plan.

This tool is not meant for women who have or have had breast cancer.





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



Yes



No



Yes



No



Lobular carcinoma in situ (LCIS)



Atypical ductal hyperplasia (ADH)



Atypical lobular hyperplasia (ALH)



None of these



Yes



No



Yes



No



Yes



No



Yes



No

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