This descriptive cross-sectional cohort study compared women who pursued genetic testing for hereditary breast and ovarian cancer (HBOC) and their at-risk relatives who did not pursue testing. Self-administered questionnaires looked at perceived risk, knowledge of HBOC risk factors, perceived severity, perceived control, psychological distress, family relationships, family communication, and decisional conflict about genetic testing. Study participants numbered 372 women aged 18 and older (200 who pursued genetic testing for BRCA1 and BRCA2 genetic mutations, and 172 of their relatives who had a greater than 10% probability of being a mutation carrier but did not pursue testing).