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Editor’s note: The US Preventive Services Task Force (USPSTF) has suggested that clinicians should discuss chemoprevention with women at high risk of breast cancer and low risk of adverse effects. However, there has been no systematic attempt to identify women at high risk of breast cancer. Efforts to routinely screen women for the risk of breast cancer and recommend intervention to those at high risk should be evidence-based to ensure that there are reasonably accurate and feasible methods for assessing risk and that interventions are effective. In order to determine whether the evidence supports screening for breast cancer risk, the current authors systematically reviewed the literature concerning methods for estimating the risk of breast cancer and interventions to reduce this risk.