Screening for breast cancer is a key public health policy for women. However, there is controversy about when women should commence screening because the evidence of benefit for women younger than 50 years remains unclear. In Australia women who are aged 40–49 years are allowed to participate in breast cancer screening, although government policy indicates that participation should be based on these women making an ‘informed choice’ about participation. This article reports on research investigating the idea of choice and screening. Semi-structured interviews were held with women in rural Tasmania who have participated in screening for breast cancer before turning age 50. The study finds that these ideas of choice and personal responsibility for health have social dimensions that are critical to understanding the decision to participate in screening.