Background <p>Coping strategies are essential for psychological well-being and healthy survivorship experience of patients with breast cancer. However, there is a research gap in the understanding of coping strategies and their associated factors among patients with breast cancer in Nigeria. This study aimed to investigate coping strategies, focusing on disengagement coping and its relationship with sociodemographic and illness-related factors in a sample of patients with breast cancer in South-South, Nigeria.</p> Methods <p>A cross-sectional study was conducted among 240 breast cancer patients at a tertiary hospital in the South‒South region of Nigeria. The participants completed a clinico-sociodemographic questionnaire to gather their background information and the 32-item Coping Strategies Inventory (CSI-32) to assess coping.</p> Results <p>The mean age of the participants was 46.8 years (<i>SD</i> = 13.4), and most participants were employed (89.2%), married (62.1%), and had children (74.6%). Most participants (<i>n</i> = 179, 74.6%) presented with advanced breast cancers (stage 3 and 4) and reported poor treatment adherence (<i>n</i> = 185, 77.1%). The findings on CSI-32 revealed a significantly greater reliance on disengagement coping (61.25%, <i>n</i> = 147) strategies (e.g., wishful thinking and social withdrawal) compared with engagement coping (38.75%, <i>n</i> = 93). Disengagement coping was significantly associated with those with fewer children, χ2(1, <i>N</i> = 240) = 4.93, <i>p</i> = .03; post-primary education level, χ2(1, <i>N</i> = 240) = 5.71, <i>p</i> = .01; being employed, χ²(1, <i>N</i> = 240) = 6.38, <i>p</i> = .01; early cancer stage, χ2(1, <i>N</i> = 240) = 2.94, <i>p</i> = .03; and poor treatment adherence, χ2(1, <i>N</i> = 240) = 3.22, <i>p</i> = .03. Following regression analysis, individuals with disengagement coping were more likely to be employed, have post-primary education, and report poor treatment adherence.</p> Conclusion <p>There is a need for psychosocial interventions to bolster healthy coping strategies amongst patients with breast cancer in this region, preferably by reducing a reliance on disengagement coping and ultimately improving psychological well-being. Such interventions need to be holistic and tailored to the unique attributes of individual patient using a patient-centered care model. Our study findings also highlight the need for future research with robust methodology, especially prospective studies, to better understand the trajectory of coping strategies in patients with breast cancer and the impacts on their wellbeing.</p>