The purpose of this article is to describe the initial development of the Women's Breast Conflict Scale, a predictive instrument designed to identify women who may be least likely to follow recommended mammography screening guidelines. This new instrument incorporates self/body image, teasing, family norms and values, and societal/media influence--themes identified from three qualitative studies and five years of qualitative data collection. The themes aided in the development of a conceptual model (Breast Conflict), which provided the framework for this instrument. A description of the traditional steps involved in instrument development is provided to aid qualitative researchers in the development of meaningful instruments that incorporate the human experience as perceived by the people for whom the instrument is designed. (Contains 1 figure, 6 tables, and 3 footnotes.)