Background <p>Breast cancer patients may experience heightened psychological distress during the preoperative period, which may adversely affect their postoperative outcomes. Despite this, routine screening is often underutilised in the cancer care pathway, especially in Low and Middle-Income Countries (LMIC). Hence, this study aims to understand the prevalence of psychological distress, anxiety, depression, and fear of surgery in breast cancer patients who are scheduled for surgical interventions.</p> Methods <p>The medical-psychological data reported among breast cancer patients scheduled for surgery were reviewed from July 2023 to December 2024. Scoring of the NCCN distress thermometer, PHQ-2, GAD-2, and surgical fear questionnaire, administered and analysed.</p> Results <p>A total of 93 underwent mastectomy and 68 underwent Breast-Conservation Surgery (BCS). Moderate to severe levels of psychological distress were reported by both the mastectomy patients and BCS. No significant difference was found in overall surgical fear, anxiety and depression depending on the type of surgery. Anxiety (29.6%) and depression (14.2%) were reported among patients.</p> Conclusion <p>The current study results highlight that the psychological state of breast cancer patients before surgery is not determined by the type of surgery they are undergoing. The findings support the feasibility of integrating routine preoperative psychological screening into surgical oncology care pathways. Such integration enables early identification and timely intervention, thereby enhancing patient preparedness, satisfaction, postoperative outcomes, and reducing healthcare disparities in LMICs.</p>