Women at high risk for breast cancer were compared to low risk women with respect to frequency of breast self-examination (BSE), knowledge and quality of BSE, and attitudinal variables. The women at high risk did not practice BSE more frequently than women at low risk, although they were more knowledgeable about BSE, more focused on breast cancer, and less confident in physician proficiency in conducting a breast exam. The rate of monthly BSE practice was low in both groups. Self-confidence about performing BSE was most strongly associated with BSE frequency in both groups. No other variables predicted BSE frequency in the high risk group. In the low risk group, knowledge of BSE technique and breast cancer focus were additional significant predictors.