This qualitative study explores the communication and decision-making strategies of five families with hereditary breast and ovarian cancer (HBOC) risk.Investigators asked female carriers of BRCA1 and BRCA2 genetic mutations to recall early knowledge and experiences concerning cancer risk.Husbands and children (aged 15-25 years) of women with HBOC risk also were interviewed on knowledge, experiences, and expectations for future decisions regarding their risk.Themes derived from the interviews suggested a need for additional studies of families with HBOC risk to address how family history and other factors influence decision making.Nurses should assess patients and their families for issues with body image and adjustment after cancer treatment and offer appropriate support.In addition, parents should be advised on when and how to tell children about their potential risk and support their testing and health-promotion decisions.