Breast cancer is the most prevalent type of cancer in women in the United States. Many modifiable and non-modifiable risk factors play a role in the development of breast cancer. Although risk assessment tools are available for predicting the risk of breast cancer development, most focus on family history. Genetic mutations do play a role in breast cancer development, but only account for up to 10% of breast cancer diagnoses. Therefore, the purpose of this study was to develop a surveillance-modeling network assessment tool that can increase awareness, offer effective prevention, and enhance early detection and treatment of breast cancer. Participants (N = 4297) completed The Rose Form, a Surveillance-Modeling Network Assessment Tool and were categorized by risk level based on modifiable and non-modifiable risk factors. Lifestyle modification and breast and ovarian cancer surveillance recommendations were provided based on risk level. Ten years after completing The Rose Form, a Follow-Up Survey was completed by 27% of the original participants. Risk classification accuracy and application of lifestyle and surveillance recommendations were assessed. The Rose Form accurately classified participants as having a history or not having a history of breast cancer (p < .05), but risk level, based on diagnosis of breast or ovarian cancer since initial participation, did not differ significantly between women classified as low, moderate, or high risk (p > .05). The Rose Project impacted lifestyle choices and screening practices in participants with 38% changing lifestyle and 52% modifying screening practices. The Rose Form was deemed a valid tool for assessing breast cancer risk with age, family history, body mass index, age at menarche, breast feeding history, age at first live birth, history of oral contraceptive and female hormone usage, and past stress level resulting in 93.1% prediction accuracy (p < .05).