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Breast Health and Cancer Risk Factors Questionnaire

Global Care Consult has developed a comprehensive survey questionnaire designed to evaluate an individual’s risk factors for breast cancer across three levels: Mild, Moderate, and Severe.

This assessment tool is part of our proactive initiative to enhance breast health and mitigate cancer risks through personalized coaching sessions.

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1. Are you a woman?

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2. Are you 40 years old or older?

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3. Do you have a family history of breast or ovarian cancer?

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4. Do you have a personal history of breast cancer or certain non-cancerous breast diseases?

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5. Do you have a genetic mutation in BRCA1 or BRCA2 genes?

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6. Did you start your menstrual periods before age 12 or start menopause after age 50?

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7. Did you become pregnant at an older age or never become pregnant?

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8. Have you ever used hormone therapy for menopause symptoms or oral contraceptives (birth control pills)?

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9. Have you ever had radiation therapy to the chest or breasts before age 30?

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10. Have you ever been exposed to the drug diethylstilbestrol (DES)?

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11. Do you have dense breasts?

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12. Are you physically active for at least 30 minutes a day on most days of the week?

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13. Are you overweight or obese after menopause?

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14. Do you smoke tobacco products regularly?

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15. Do you drink alcoholic beverages regularly?

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16. Do you eat a balanced diet that is rich in fiber, fruits, vegetables, and low-fat dairy products?

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17. Do you avoid foods that are high in sugar, fat, and processed ingredients?

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18. Do you limit your intake of red meat and processed meat?

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19. Do you consume foods that have anti-inflammatory properties such as spices and herbs?

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20. Do you practice stress management techniques such as meditation, yoga, breast massages or breathing exercises?

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21. Do you get enough sleep and rest every night?

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22. Do you avoid exposure to environmental pollutants and chemicals that may affect your hormones?

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23. Do you perform self-breast awareness examination regularly to check for any changes or abnormalities in your breasts?

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24. Do you get regular mammograms or other screening tests for breast cancer as recommended by your health care provider?

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25. Do you wear appropriate size, type, fitting, material & support bra?

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26. Do you feel satisfied with overall breasts and nipples health, skin and development?

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27. Did you ever had nipples discharge without pregnancy and lactation?

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28. Do you get breast or nipples skin rashes, redness or infection?

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29. Do you feel increasing asymmetry between breasts and nipples shape, size, skin or sensations?

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30. Do you have Adequate information regarding Self Breast Awareness and the importance of Early Detection in Breast diseases and Cancer outcome?

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31. Do you consume foods that are rich in vitamin D and calcium?

Thank you for completing. Please fill the form below to get your result and recommendations.

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