--- - |2+ Abstract Objective Adherence to adjuvant endocrine therapy (AET) in breast cancer survivors is suboptimal. Using the theory of planned behavior (TPB), this study aimed to identify the strongest predictors from the TPB of AET intentions and past behavior and assessed whether ambivalence and anticipatory emotions increased the predictive capacity of TPB. Methods 280 women diagnosed with hormone positive (HR+) breast cancer who filled at least one prescription of AET responded to a survey measuring TPB constructs, attitudinal ambivalence, and anticipatory emotions. The outcomes were intentions to adhere to AET and past medication adherence (previous two weeks). Results The TPB explained 66% of intentions to adhere to AET (p<0.001). Ambivalence did not improve the TPB model's predictive value. When emotions were included with TPB, the model explained 70% of adherence intentions F(11,226)= 52.84, p <.001 (R2c= .70). This increase of 4% in predictability was statistically significant (ΔR2=0.04), F(6, 226)=7.90, p <.001. Women who self‐reported non‐adherence in the past two weeks differed significantly in the TPB variables, ambivalence, and anticipatory emotions from adherent women. Non‐adherent participants reported lower future intentions to adhere F (1, 236)=5.63, p=.018. Conclusions Results suggest key concepts, such as anticipatory positive emotions, that should be addressed in future interventions to enhance AET adherence and survivorship. - Psycho-Oncology, Volume 0, Issue ja, -Not available-.