Although breast cancer risk increases with age, most studies show that mammography use decreases. A 15-minute telephone survey of 548 women health maintenance organization (HMO) members aged 65 to 74 who had not obtained a mammogram within the past year was undertaken to identify sociodemographic factors as well as knowledge, belief, and attitudinal characteristics associated with mammography history. Women who had never had a mammogram were less likely to have received a physician's recommendation and more likely to express negative attitudes about mammography, such as having a mammogram means "looking for trouble" and "makes me nervous." In addition, they expressed doubts about their need to have a mammogram and reported that "other problems" prevented them from having a mammogram. These results suggest that women who have never had a mammogram may require more intensive interventions to encourage them to obtain mammograms. In addition to receiving a mammography recommendation from their physicians, they might benefit from individual or small group educational sessions where negative attitudes about mammography could be explored and modified.