Breast cancer has emerged as one of the most common malignancies among women globally, constituting a major cause of female cancer-related mortality. Among breast cancer patients, the incidence of emotional disorders is notably high, significantly impacting their quality of life and disease prognosis. Traditional Chinese medicine (TCM) offers numerous advantages in addressing emotional disorders. However, there are currently no standardized diagnostic or therapeutic guidelines for TCM management of emotional disturbances accompanying breast cancer. This guideline, authored by a panel of experts in the field of TCM, including specialists in breast oncology, breast surgery, and psychosomatic medicine, is based on the current best evidence and expert insights. It standardizes the terms and definitions, diagnostic criteria, etiology and pathogenesis, clinical staging, and treatment principles of breast cancer with emotional disorders. Meanwhile, the guideline establishes six main TCM syndrome types and their corresponding treatment strategies. Its purpose is to serve as a reference and foundation for the clinical syndrome differentiation and treatment of emotional disorders in breast cancer patients.