“I am here today for a wellness visit. I’d like to discuss a few concerns. Especially my risk for breast cancer. Just recently both my mother, who’s 63 and my first cousin on my mother’s side were diagnosed with breast cancer. I would like to know whether that increases my risk and if so how much” HPI: Ms. Cross is a healthy 41-year-old who presents for a well-woman examination. She has no major health issues but is concerned about her risk for breast cancer. She is married with two boys age 6 and 8. The patient reports a normal mammogram at age 40. She has a history of fibrocystic breast disease. As a result she is concerned that she will not be able to identify a lump. She has no active medical complaints or health problems past or present. She is concerned about her risk of breast cancer because both her mother (age 63), and maternal first cousin (age 44) have been recently diagnosed with intraductal breast cancer. She takes no regular medications but does take vitamin E for fibro cystic breast disease. She will periodically take aspirin or acetaminophen for headaches. She cannot remember when her last physical was. Her immunizations are up to date. Last gynecological exam was 18 months ago. Patients menarche age 10.5; first pregnancy age 33; second pregnancy age 35; she breast-fed each of her two infants for only four months each. The patient, reports a normal baseline mammogram at age 40, (report not available) and a history of fibrocystic breast disease.