This study examined the use of CAM by women with varying levels of familial and perceived risk of breast cancer with the goal of preventing breast cancer. Cross-sectional data on CAM use were collected on 2198 women (mean age 63 years) personally unaffected by breast cancer in the Minnesota Breast Cancer Family Study. CAM use was compared across women at high, moderate or average risk based on family history, as well as across categories of perceived risk of breast cancer. CAM use was also examined in relation to screening and general health behaviours, worry about breast cancer, and optimism. Half (49.5%) of the women reported using at least one CAM modality with the intention of preventing breast cancer. Univariate analyses indicated that greater overall CAM use was related to greater perceived risk, more general health behaviours, more breast cancer screening behaviours, greater optimism, and higher educational attainment. Multivariate analysis revealed that general health behaviours, education and optimism were significant predictors of CAM use when in the same model with perceived risk and breast cancer screening behaviours.