Objectives To assess reproductive concerns in patients of childbearing age with breast cancer and examine the relationship between self-disclosure, resilience and reproductive concerns.Design Cross-sectional survey.Setting Five tertiary first-class general hospitals in Sichuan Province, Southwest China.Participants A total of 319 patients with breast cancer of reproductive age who were hospitalised in the breast oncology department participated in this study.Main outcome measures Primary outcomes were the relationship between resilience, self-disclosure and reproductive concerns, and mediating effect analyses. Secondary outcomes included the status of reproductive concerns.Results The model accounted for 39.1% of the variance in reproductive concerns. Self-disclosure had a direct negative effect on reproductive concerns (β= −0.371, p=0.001). Resilience had a direct negative effect on reproductive concerns (β= −0.349, p=0.001) and a direct positive effect on self-disclosure (β=0.507, p=0.001). Furthermore, self-disclosure partially mediated the relation between resilience and reproductive concerns (β= −0.177; SE=0.041; 95% CI −0.261 to –0.104; p