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  • Breast Cancer History And Risk Assessment - Patient Information Form

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BREAST CANCER HISTORY AND RISK ASSESSMENT Patient Information Form 1. Name First Last 2. Today s date (month/day/year) 3. Date of birth (month/day/year) 4. Age 5. Height (feet/inches) 6. Weight (pounds).

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Gail model 1 accurately predicted breast cancer risk in American women (pooled E/O = 1.03; 95% CI 0.76–1.40). The pooled E/O ratios of Caucasian-American Gail model 2 in American, European and Asian women were 0.98 (95% CI 0.91–1.06), 1.07 (95% CI 0.66–1.74) and 2.29 (95% CI 1.95–2.68), respectively.

A woman is considered to have a high risk if she has at least a 1.67% chance of developing breast cancer in the next five years, or a lifetime risk of at least 20%.

Breast cancer risk assessment takes into account several aspects of your gynecologic health, personal history of breast biopsies, breast density and family history to calculate whether you may be more likely than average to develop breast cancer.

The Breast Cancer Risk Assessment Tool (the Gail Model) The tool calculates a woman's risk of developing breast cancer within the next 5 years and within her lifetime (up to age 90).

The feelings that come up after a breast cancer diagnosis can sometimes mirror the five stages of grief identified by psychiatrist Elisabeth Kübler-Ross in 1969. These may be familiar to you, and include denial, anger, bargaining, sadness and depression, and acceptance.

A woman's risk is considered low if her five-year risk of developing breast cancer is less than 1.6%; it is considered high if she scores above 1.66%. (All women who are over 60 have a score of at least 1.66 and are considered high risk, based on the Gail Model.)

ing to the Gail model, women with the breast cancer risk of >1.66% were considered as high-risk ing to the estimated 5-year breast cancer- risk assessment.

The Gail Model The tool uses a woman's own personal information to estimate risk of developing invasive breast cancer over specific periods of time, including: Age. Age at the start of menstruation. Age at first live birth of a child. Number of first-degree relative (mother, sisters, daughters) with breast cancer.

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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