Purpose/Objectives: To conduct an investigation of women's experiences related to adjuvant endocrine therapy (AET) and managing AET-related symptoms. Research Approach: Qualitative, focus group design. Setting: Main campus of the University of Pittsburgh in Pennsylvania. Participants: 14 breast cancer survivors, aged 50 years or older, with AET-related symptoms. Methodologic Approach: Semistructured discussion guides were used to elicit recollections of conversations with healthcare providers about starting AET, symptom experiences, symptom management, and suggestions for improving management. Audiotaped discussions were transcribed and analyzed to identify themes. Findings: Women reported that, initially, AET was not viewed as a choice, but rather as the necessary next step to save their lives. After starting AET, women experienced difficulties making sense of, communicating about, and managing unanticipated AET-related symptoms. Women who experienced persistently bothersome symptoms began weighing the pros and cons of AET to decide whether to continue treatment. Conclusions: Focus group findings suggest multiple opportunities to better prepare patients for AET and to improve assessment and management of AET-related symptoms. Interpretation: By exploring AET-related symptom experiences, nurses may be able to promote AET adherence in breast cancer survivors.