Progress genetics has endless implication for primary care and for people at risk for hereditary breast cancer. Nurse practitioners will be increasingly challenged to order and interpret genetic tests, provide genetic counseling, and assume responsibility for protecting patient privacy. Yet primary care practitioners may not be completely prepared to provide the necessary background information. This article provides guidelines for evaluating family history risk for inherited breast cancer risk. Also discussed are implications for presymptomatic testing of the BRCA1 and BRCA2 genes for adult-onset breast and ovarian cancer.