The social factors that impact Caucasian middle-class women's practice of breast self-examination (BSE) were examined through in-depth interviews with 15 women who were selected to represent a mix of women who practiced BSE monthly, occasionally, or never. The meaning of BSE was analyzed in relation to body image and the social definition of being a woman. The analysis was framed within the context of the literature on the following topics: social constructionism; women as gendered learners; the concept of body image; and the practice of BSE. All five women who practiced BSE monthly learned BSE from their gynecologist, were satisfied with their bodies and accepted their body image and breast size, viewed health or wellness in totality, took time for self-care behaviors, understood what normal breast tissue is, and were able to discuss their bodies openly. All the women who practiced BSE occasionally desired to change their breast size or shape, compared themselves to an ideal based on the media and advertising, and were casual about performing BSE even though they all expressed fears about breast cancer. The women who did not practice BSE did not share common views regarding their body image, views on health and wellness, and understanding of what constitutes normal breast tissue. (12 references) (MN)