Pathological mood changes, mainly depression, occurring during the diagnosis and treatment of breast cancer are clinically called breast cancer related depression(BCRD). A large number of epidemiology and clinical studies have confirmed that BCRD is complex， difficult to treat,and has a poor prognosis. Most of the existing clinical treatments are postoperative chemotherapy for breast cancer and antidepressant drugs, which treats breast cancer and depression as two independent diseases,with many defects such as low efficiency and strong adverse reactions. Traditional Chinese medicine（TCM）has a unique value in the prevention and treatment of breast cancer-related depression by virtue of its significant advantage of regulating multiple pathways and targets with its multiple components at the same time.In this paper,we review the mechanism of BRCD and the therapeutic mechanism of TCM from the aspects of neurological disorders, inflammatory immune response, and intestinal flora disorders, with a view to providing certain references for the clinical application and research of TCM in the treatment of BCRD.