Dear Center for Breast Care patient;

American women have a 1-in-10 chance of developing breast cancer and a 1-in-70 chance of developing ovarian cancer during their lifetime. For some women, however, the risk is higher based on their family history.
Cancer that develops in several members of a family is sometimes caused by a gene mutation (abnormality). Mutations in the BRCA1 & 2 genes are believed to cause most cases of hereditary breast and ovarian cancer that can be passed down from mothers or fathers to their children.
If you have a personal or family history of breast or ovarian cancer, you may be thinking of genetic testing. Genetic testing may provide information on the likelihood of developing these diseases in the future. Knowing your cancer risk, including the risk for recurrence, can help you and your doctor make informed decisions about your health care.
Below is a questionnaire that can quickly evaluate your personal and family history for breast and ovarian cancer.

Please place a check-mark (x) in the boxes below, for yourself and for each member who have had cancer as indicated.

	BREAST CANCER BEFORE AGE 50	OVARIAN CANCER AT ANY AGE
Yourself
Mother
Sister(s)
Daughter(s)
Mother's side
Grandmother
Aunt(s)
Cousin(s)
Father's side
Grandmother
Aunt(s)
Cousin(s)
Any Males with Breast Cancer at any age

If you have:

- Two (2) or more check marks (x) in the above table, OR
- One (1) check mark in the above table and you are of Ashkenazi Jewish descent, OR
- Any male relatives with breast cancer at any age

Please [email] or call us at the Center for Breast Care (561) 361-2141 and ask for our Risk Assessment Program.