The epidemiology of breast fluid secretion was studied on the basis of nipple aspirates of breast fluid obtained from 3,929 nonlactating women of various racial groups. The results confirmed and extended earlier findings by our group: Variation in the proportion of secretors was related to most breast cancer risk factors, including age, race, age at menarche, age at first pregnancy, age at menopause, clinically diagnosed fibrocystic disease, menopausal estrogen use, and cerumen phenotype. Secretory activity as measured by nipple aspiration appeared to reflect hormonal and genetic effects on breast epithelium.