Objective To explore the effect of predictive nursing on postoperative complications and breast cosmetic effect in breast cancer patients with plastic breast conserving surgery. Methods A total of 80 patients with breast cancer admitted to our hospital from March 2022 to March 2023 were selected as the research objects. They were divided into control group and experimental group by random number table method, with 40 patients in each group. The control group was treated with routine nursing, and the experimental group was treated with predictive nursing. The psychological status, quality of life, breast cosmetic effect, complications, recovery time and hospitalization time were compared between the two groups. Results After nursing, the SAS score and SDS score of the experimental group were lower than those of the control group (P