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Calculate Your Breast Cancer Risk
(for women 35-84)
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Calculate Your Breast Cancer Risk


Background Information

Date of Birth:      Month    Day    Year
(This information is required to generate your estimated breast cancer risk, since age is a risk factor. The program calculates risk for women ages 35 thru 84.)

Race:                          

If Other, Specify:           
(Race is a factor in determining your individualized risk. If you are of mixed racial/ethnic background, choose the category with which you most closely identify.)



Family History (Include only her biological mother and daughter(s), and her biological
sister(s) who share both her parents; information about half-sisters should not be included.)

If adopted, click here

Does/Did her mother have breast cancer?          yes no Not sure

Does/Did her daughter(s) have breast cancer?    yes no Not Applicable/Not sure

             If Yes, Number of daughters with breast cancer    

Does/Did her sister(s) have breast cancer?          yes no Not Applicable/Not sure

             If Yes, Number of sisters with breast cancer