OBJECTIVE The purpose of this study was to gain a better understanding of the cultural meanings that shape the breast cancer screening behavior of older African-American women. METHODS Qualitative research methods elicited social and cultural themes related to breast cancer screening. METHODS Focus group interviews were conducted in the natural settings (churches, etc.) of older African-American women. METHODS Interviews were conducted with 132 members from 14 social networks of older African-American women. METHODS A focus group guide asked about 1) perceived risk of breast cancer, 2) behavioral intentions about breast cancer screening, 3) health seeking behavior, and 4) social support. RESULTS For older African-American women: other health concerns are of more concern than breast cancer; age is generally not recognized as a risk factor for breast cancer; fear of finding breast cancer and its social consequences are salient barriers to mammography; they tend to rely on breast self-exam rather than mammography to detect a breast problem; cost may be more an issue of competing priorities than cost per se; the tradition is to go to doctors for a problem, not prevention; and women in their own social networks are important sources of social support for health concerns. CONCLUSIONS These data offer explanations for mammography screening in older African-American women and emphasize the strength of naturally existing sources of social support for designing interventions to increase breast cancer screening.