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  • Cancer Family History Questionnaire - Amazon S3

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CANCERFAMILYHISTORYQUESTIONNAIRE PersonalInformationPatientName: DateofBirth: Age: Gender(M/F): TodaysDate(MM/DD/YY): HealthCareProvider: Instructions:Thisisascreeningtoolforcancersthatruninfamilies.Pleasemark(Y)forthosethatapplytoYOUand/orYOURFAMILY.

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Having a first-degree relative (mother, sister, or daughter) with breast cancer almost doubles a woman's risk. Having 2 first-degree relatives increases her risk by about 3-fold. Women with a father or brother who has had breast cancer also have a higher risk of breast cancer.

there are 2 or more close relatives on the same side of the family (your mother's or your father's side) with the same type of cancer, or with particular types of cancer that are known to be linked – for example, breast and ovarian cancer or bowel and womb cancer.

Having a mother, sister or daughter (first degree relative) diagnosed with breast cancer approximately doubles the risk of breast cancer. This risk is higher when more close relatives have breast cancer, or if a relative developed breast cancer under the age of 50.

Two or more first– or second-degree relatives from the same side of the family with breast cancer, if at least one breast cancer was diagnosed before age 50.

Hereditary cancer is found through genetic testing. This is the analysis of a person's genes, chromosomes, or proteins. Testing can: Help predict the risk that someone will get a disease.

Both men and women who inherit a harmful BRCA1 or BRCA2 variant, whether or not they develop cancer themselves, may pass the variant to their children. Each child has a 50% chance of inheriting a parent's variant.

Everyone has two copies of the BRCA1 and BRCA2 genes, one copy inherited from their mother and one from their father.

Some people think you can only get breast cancer from your mother's side of the family. But that's a myth. Breast cancer can come just as easily from your father's side.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232