BC-Predict Questionnaire

Thank-you for your interest in the BC-Predict research study, we would be grateful if you would now answer a couple of questions to check your eligibility and then complete the questionnaire. Please see below for a list of topics that the BC-Predict questions will cover:

  • Basic information: date of birth, height, weight, ethnicity
  • Breast surgeries
  • Your cancer history (if applicable)
  • Your genetic testing (if applicable)
  • Your breast biopsy (if applicable)
  • Menstruation, pregnancies, and child births
  • Menopausal status
  • Reproductive surgeries
  • HRT use
  • Family history: relatives, cancer history, genetic testing
  • Additional questions (optional): exercise, smoking, alcohol, breastfeeding, clothes size, contraceptive, IUD with hormones, polycystic ovaries, diabetes

You will be able to answer some of the questions, save and return to the questionnaire at a later date if you wish, as long as this is completed and submitted within 6 weeks of your breast screening appointment. If you are unable to answer some of the some questions just do the best you can and select unknown if you are unable to answer or cannot find the information you need to answer the question.

If you have any queries please contact the BC-Predict team on 0161 291 4408 or BCPredict@mft.nhs.uk