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Ask Your Care Provider
Ask Your Care Provider
Print out the Health History Form and ask your health care provider to help you.

what You'll Need


BreastCancerTrials.org uses information about your breast cancer diagnosis and treatment to match you to trials.

To answer the questions on the BCT Health History Form, you will need the following information regarding your diagnosis and treatment:

Medical Reports

Ask your doctor for the following:

  • Pathology Report: The pathology report explains precisely what the pathologist saw in the tumor tissue. Learn how to read a pathology report.
  • Breast Cancer Staging Information: Breast cancer staging ranges from stage 0 (DCIS) to stage IV (metastatic disease). The cancer’s stage is based on the tumor’s size and how far the cancer has spread. Learn more about staging.
  • Imaging Reports: The most common imaging tests are mammography, ultrasound, bone scans, CT, MRI, and PET scans. Learn more about imaging reports.

Your Breast Cancer Treatment or Survivorship Plan

If you received a treatment summary or survivorship care plan from your doctor, it may provide all of the information you need to complete the BCT Health History Form.

Make A Plan

The American Society for Clinical Oncology has developed materials that patients and doctors can use to develop treatment summaries and survivorship care plans. You can get these forms here.