This article reviews recent literature on age differences in psychological adjustment to breast cancer. Overall, studies have shown that older women experience less psychological distress in terms of anxiety, depression, and posttraumatic stress symptoms. Age differences in health status, treatment provision, social support, and other life circumstances may contribute to differential patient adjustment. Coping also may mediate the relationship between age and affective responses, but the confounding of coping and distress in widely used inventories precludes definitive conclusions. Future research should explore the contextual mechanisms underlying age differences in adjustment.