Vagina Institute Lab. | Illness and damage to the breasts


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	Breast illness and damage to the breasts. The following questionnaire deals with breast illnesses and damage which may occur to your breasts. Whether you have suffered from something to just thinking about what might happen if your breasts were to get some sort of disease.

Gender:

Female

Age:

Height:

Country:

Bust size:

Ethnicity:

Waist size:

Marital:

Hip size:

Orientation:

Tell us about your breasts.

1. Do you fear any or specific breast disease or illness, if so, which do you worry about most?

2. Has there been any breast illness in your family or relatives?

3. Have you suffered any of the following conditions (select all that apply)?

Malignant diseases
Carcinoma
Breast cancer
Paget’s disease

Benign conditions
Mastitis
Breast cysts
Fibroadenoma (benign tumor)
Nipple discharge (galactorrhea) Mammary fistula
Cysts
Epithelial hyperplasia
Epithelial metaplasia
Papillomas
Adenosis
Galactocoele

Inverted nipples
Infections and inflammations
Deformations
Severed nipple
Lopsided breasts

4. If you have suffered from any disease or medical condition, how has your life changed because of it?

5. How would you feel if you were to fall ill and have to have one or both of your breasts removed?

6. What are your thoughts on breast cancer and having to deal with it?

7. Anything additional that you would like to add about breast health issues.


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