Breast cancer prevention must include interventions aiming at both reducing the risk of breast cancer (primary prevention) and identifying cancers at an early stage (secondary prevention). Sweden has one of the best breast cancer screening programs globally, but women are still screened without taking risk of breast cancer or difficulties diagnosing a cancer into consideration. Today it is possible to identify women at high risk of breast cancer and those women that have high mammographic density. These women should be offered individualised screening. Women at very high risk of breast cancer should be offered primary preventive initiatives.