"AI development for healthcare aims to enhance medical decision-making through risk evaluation. Scholars have focused on improving the accuracy of Breast Cancer AI Risk Assessment Tools (BC-AIRAT), yet these tools remain underutilized in clinical practices. This provides an opportunity to explore how these tools are used and how they may support risk communications. We conducted a three-phase study, with clinicians and patients, in the context of the United States healthcare system, including formative interviews that surface the challenges of BC-AIRAT practices, design probe re-purposing BC-AIRAT as supporting risk communications, and design probe-driven interviews with diverse stakeholders. Our findings surface the gap and opportunity for designing AI-mediated risk communication tool, highlighting the participants’ reflections on AI for managing risk assessment workflows, mediating fragmented breast health guidelines, and delivering information to patients for proactive decision making. We conclude with design implications for using AI as a mediator in breast cancer risk communication."