We assessed the association between Wolfe mammographic patterns and breast cancer risk factors among 239 women who attended the Breast Evaluation Unit screening program of the Comprehensive Cancer Center of Alabama, University of Alabama at Birmingham, from November 1984 through April 1986. Evaluation consisted of a breast cancer risk assessment based on a questionnaire concerning commonly accepted breast cancer risk factors, along with a physical breast examination and mammogram. Increased age, weight, and parity were associated with a low-risk pattern; late age at first birth, alcohol consumption, and oral contraceptive use were associated with a high-risk pattern. Our findings support those of previous studies, except for those concerning use of oral contraceptives. Further exploration is needed to ascertain whether the association of oral contraceptive use with high-risk patterns indicates a pathway through which estrogens may increase the risk of breast cancer. © 1993 Southern Medical Association.