Although adjustment to breast cancer is an ongoing process, few studies have assessed the psychosocial adjustment of patients and husbands over an extended period of time. The purpose of this descriptive study was to compare the psychosocial adjustment of mastectomy patients and their husbands at three points in time: 3 days, 30 days, and 18 months post-surgery. Data were obtained from 41 mastectomy patients and their husbands (n = 82 subjects) at each time point. Three instruments with established reliability and validity were used to measure three components of psychosocial adjustment: the Affects Balance Scale (mood), the Brief Symptom Inventory (symptom distress), and the Psychosocial Adjustment to Illness Scale (role functioning). Repeated measures Analysis of Variance was used to compare changes in subjects' adjustment levels over time. Results indicated that while subjects' levels of mood and levels of role functioning improved over time, subjects' levels of distress did not improve over time. Distress levels reported by patients and husbands at 18 months were similar to levels reported at 3 days and 30 days post-surgery. The findings suggest that difficulties in psychosocial adjustment are not confined to the early phase of illness but persist over time for both patients and husbands. Nursing implications center on the importance of long-term, ongoing assessment.