Objectives.The aim was to examine the role of trait anxiety and diagnosis on depressive symptoms and fatigue in women with early stage breast cancer or benign breast problems.Design.A prospective follow‐up study was performed in order to find predictors of depressive symptoms and fatigue.Methods.From the 169 participating women, 81 patients had breast cancer and 88 benign breast problems. Questionnaires for depressive symptoms and fatigue were completed before diagnosis (T1) and 1 (T2), 3 (T3), and 6 (T4) months after diagnosis (benign patients) or surgical treatment (breast cancer patients). A trait anxiety questionnaire was only completed before diagnosis was known.Results.Trait anxiety, assessedbeforediagnosis, was the only significant predictor of depressive symptoms at T4, even when depressive symptoms at baseline was included in the analysis. Fatigue at T4 was predicted by fatigue at baseline and trait anxiety. Demographic characteristics, diagnosis (benign or breast cancer) and adjuvant treatment (chemotherapy, radiotherapy, hormone therapy) did not play a role. Patients with breast cancer or benign breast problems scoring high on trait anxiety, scored higher on depressive symptoms and fatigue than the other patients, at all time points.Conclusions.Trait anxiety plays a role in experiencing depressive symptoms and fatigue over tim