Background <p>The incidence of breast cancer is high, and chemotherapy is easy to cause taste changes, induce cancer anorexia, affect treatment tolerance and quality of life. However, clinical attention is mostly paid to obvious symptoms, ignoring taste changes and cancer anorexia, and patients rarely report actively.</p> Objectives <p>To explore the influence of chemotherapy-induced taste alteration on cancer anorexia in patients with breast cancer, as well as the mediating role of psychological resilience and family support.</p> Design <p>A cross-sectional study.</p> Methods <p>By using the convenience sampling method, breast cancer patients who visited a tertiary general hospital in Henan Province were selected as the research subjects. Questionnaire surveys were conducted through the general information questionnaire, the Chemotherapy-induced Taste Alteration Scale, the Cancer Anorexia Scale, the Psychological Resilience Scale, and the Family Support Scale, and 346 valid data were collected.</p> Results <p>(1) Cancer-related anorexia was negatively correlated with Chemotherapy-induced taste alteration (<i>r </i>= -0.377, <i>P</i> &lt; 0.01), and positively correlated with psychological resilience and family support (<i>r</i> = 0.242, 0.318, <i>P</i> &lt; 0.01); (2) The direct effect of chemotherapy-induced taste alteration on cancer anorexia in breast cancer patients was significant (<i>β </i>= -0.108, <i>P</i> &lt; 0.001); (3) Between chemotherapy-induced taste alteration and cancer-related anorexia, psychological resilience and family support not only play a mediating role alone but also jointly play a chain mediating role, with a total mediating effect of 28.48%.</p> Conclusions <p>Chemotherapy-induced taste alteration can not only directly affect cancer anorexia in breast cancer patients, but also indirectly affect cancer anorexia through psychological resilience and family support.</p>