Introduction: Although breast cancer (BC) rates are declining in White non-Hispanic American women, they are increasing among Vietnamese American women (VAW) at 1.2% (95% confidence interval [0.1, 2.2]) per year. BC screening rates (64%) are below the national rates (81.1%). This article explores VAW’s beliefs about BC and screening. Method: Using community-based participatory qualitative descriptive methods, 40 VAW were recruited from Oregon, and four focus groups were conducted. A directed content analysis was used. Results: Main themes were as follows: deferred to a health care provider or relying on self-detection and symptoms; fear of BC versus fear of procedural pain; limited knowledge; motivation by observing others’ journey in BC death or survivorship; body image concern; “living carefree,” “good fortune—having good health”; and coverage for a mammogram expense means health care access. Discussion: Tailored interventions should address mammogram knowledge, fear, erroneous information, body image, fate and luck, and promoting access.