Background: Although elevated levels of distress have been well documented among cancer patients receiving active treatment, the magnitude of and contributors to distress in cancer survivors are yet to be well established. The purpose of this investigation was to evaluate the presence of distress among breast cancer survivors (BCS) and to investigate demographic, psychosocial, tumor and treatment related variables that may be associated with distress in this population. Methods: A retrospective chart review was done that includes 81 female BCS, 21 years or older, who received care at the Stony Brook Cancer Center Survivorship Clinic and completed the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) form between October 2012 and June 2014. Descriptive statistics were used to describe the demographic, psychosocial, tumor and treatment characteristics for the study sample and logistic regression models were used to evaluate the relationship between elevated distress and the factors outlined above. The regression results are presented as odds ratios (ORs) and 95% confidence intervals (CIs). Data were analyzed using SPSS version 21. Results: Approximately one-half of BCS (50.6%) reported a clinically significant distress level (4 or higher). Those who were on an anxiolytic or anti-depressant medication tended to have higher levels of distress (OR: 3.10; 95% CI: 0.90-10.74; P = 0.07) and age greater than 60 years at the time of diagnosis was negatively correlated with distress (OR: 0.24; 95% CI: 0.07-0.84; P = 0.03). BCS with clinically significant distress (4 or greater) reported more problems in the emotional domain components of the DT, whereas patients with low distress (less than 4) reported more problems on the physical domains. Conclusions: Findings from this study indicate that more than half of BCS experienced distress during the survivorship phase, which frequently manifested as emotional and physical problems. Although preliminary, these data suggest the need to develop targeted screening strategies for early recognition and interventions to alleviate distress in this population.