This study aimed to evaluate the effect of psychological nursing intervention combined with family-like care on prognosis and mental health in breast cancer patients undergoing radical mastectomy. A retrospective analysis included 100 patients divided equally into control (routine nursing) and experimental (psychological nursing plus family-like care) groups. Key outcomes measured were nursing efficiency, patient satisfaction, adverse reactions, anxiety and depression scores, mental status, sleep quality, quality of life, and incidence of negative emotions over 4 weeks post-surgery. Results showed the experimental group had significantly higher nursing efficiency, satisfaction, and quality of life scores, alongside lower rates of adverse reactions, anxiety, depression, poor mental status, and negative emotions at all-time points (P < 0.05). These findings indicate that combining psychological nursing with family-like care effectively reduces postoperative negative emotions and enhances recovery, highlighting its clinical value in breast cancer care.