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Should you consider genetic testing for hereditary cancer risk?

1. Have you or a close blood relative ever tested positive for a gene mutation associated with hereditary cancer?
Yes.
No.
2. Have you or a close blood relative ever been diagnosed with any of the following? Please select all that apply
Pancreatic cancer
Male breast cancer
Ovarian or fallopian tube cancer/ peritoneal cancer
Metastatic breast cancer (cancer that spread outside of the breast)
Metastatic prostate cancer (prostate cancer that spread outside of the prostate)
Female breast cancer diagnosed under age 50
Triple negative breast cancer diagnosed under age 60
Colon/uterine tumor testing with abnormal protein staining diagnosed under age 50
Endometrial (uterine cancer) cancer diagnosed under age 50
“Abnormal” colon/uterine tumor testing
Breast or prostate cancer and Ashkenazi Jewish ancestry
None of the above
3. Please select all of the following that apply to your family:
Breast and prostate cancer on the same side of the family
Three or more cases of breast cancers on the same side of the family
Three or more cases of prostate cancer on the same side of the family
Two or more cases of colon/uterine cancer on the same side of the family, at least one diagnosed under age 50
Three or more cases of colon/uterine cancer on the same side of the family
None of the above
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