During 2005, a risk assessment tool based on the Gail model was used to calculate the five-year risk of developing breast cancer for 445 women who live in socioeconomically disadvantaged urban communities in western Pennsylvania and who attended health fairs and other community-sponsored activities. This tool allowed us to evaluate each woman and advise her of her risks in a process lasting 15-20 minutes. Of the 445 women, 71.7% were black and 21.6% had a higher than average risk. The proportion of white women at high risk was significantly greater than the proportion of black women at high risk (33.3% vs. 16.9%; P < 0.01). The Gail model assessment tool for use in low-income and minority populations holds promise because it is noninvasive, is easy to use and provides immediate data about risk. This risk communication may help encourage minority and low-income women to receive screening mammography. It has the potential to improve breast cancer screening rates.