PURPOSE: Patients with breast cancer may exhibit signs of psychological distress upon initial diagnosis of cancer. Previous studies have reported that depressive symptoms in the patients with breast cancer may have a harmful effect on their prognosis. Psychological characteristics of patients with depressive symptoms were investigated, comparing them to those of patients without depressive symptoms. METHODS: Thirty-eight patients initially diagnosed with breast cancer were recruited from the Department of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital. The psychological symptoms of the patients were assessed using the Beck Depression Inventory (BDI), the Montgomery- Asberg Depression Rating Scale (MADRS), the State-Trait Anxiety Inventory and the Self-Awareness Scale. Their mental coping was assessed using the Korean Mental Adjustment to Cancer scale (KMAC) and their health-related quality of life was assessed with the Short Form 36-item Health Survey (SF-36). The cut-off points of BDI and MADRS of the depressed subgroup were 13 and 10, respectively. Psychological characteristics of depressed patients were compared with non-depressed patients. Statistical analyses were performed using SPSS 13.0 packages. RESULTS: Sociocultural variables, including age, education year and cancer stage, were not different between the two patient groups. The depressed group showed significantly higher state-anxiety and lower trait-anxiety and positive selfawareness scores compared to the non-depressed group. In the SF-36 Health Survey, the depressed group showed a significantly lower mental health component score of fightingspirit factor, in addition to a higher score of anxious-preoccupation factor in the KMAC compared to those of the nondepressed group. CONCLUSION: When patients were diagnosed with breast cancer, depressed patients may suffer from a poorer quality of mental health and more psychological suffering. This suffering can lead to maladaptive compliance in following treatment. Therefore, depressive symptoms need to be investigated and managed at the initial step of breast cancer.