["Journal of Traumatic Stress, EarlyView. ", "\nAbstract\nChildhood abuse and neglect worsen physical and mental health through adulthood. This study examined how childhood adversity affected physical and psychological symptoms associated with breast cancer treatment and survivorship at three points within the cancer trajectory. Breast cancer survivors (N = 209) were recruited following diagnosis and completed three visits at pretreatment, 6 months posttreatment, and 18 months posttreatment. All survivors completed the Childhood Trauma Questionnaire to assess abuse and neglect exposure prior to 18 years of age. At each visit, participants completed self‐report measures of depressive symptoms, anxiety symptoms, pain, fatigue, and sleep quality. When controlling for disease‐related variables, sexual abuse significantly interacted with study visit to predict pain, p = .002. No other significant interactions emerged. Analyses of main effects revealed that breast cancer survivors who experienced higher rates of each abuse or neglect type experienced poorer sleep quality, Bs = 0.20–0.39, p < .001–p = .002; higher fatigue, Bs = 0.81–1.4, ps < .001–p = .020; more depressive symptoms, Bs = 0.55–0.56, ps ≤$ \\le $ .001; and higher anxiety symptoms, Bs = 0.35–0.54, p < .001–p =  .002. Only physical neglect was significantly associated with pain, B = 0.12, p = .041. Results suggest that breast cancer survivors who experienced abuse and neglect earlier in life are at increased risk of adverse physical and psychological symptoms throughout survivorship. Providers should consider screening for early life trauma to understand unique risks associated with navigating breast cancer treatment and survivorship.\n"]