Married women's adjustment to breast cancer is positively influenced by their husbands' emotional support and by both spouses' active coping strategies. However, little is known about how women's adjustment is related to their husbands' perceptions of their psychosocial impairment. The current study examined the relationships among wives' coping strategies, the extent of congruence between wives' and husbands' perceptions of wives' adjustment, and wives' mood disturbance in 45 women with Stage I or II breast cancer and their husbands. Mediational analyses demonstrated that discrepancies between husbands' perceptions of wives' adjustment and wives' perceptions of their own adjustment mediated the relationship between wives' use of avoidant coping strategies and wives' mood disturbance. The findings suggest that husbands' over- or under-estimation of wives' adjustment may have a negative impact on wives' mood. Implications for future research are discussed.