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Background: Cancer is a complex, debilitating, and common disease with many dimensions, consequences, and psychological, biological, and social complications. We aimed to investigate the structural equations of treatment adherence based on emotional, cognitive regulation mediated by coping styles in women with breast cancer undergoing chemotherapy. Methods: The present study was a correlational study using structural equation modeling. The statistical population included patients with breast cancer referred to specialized cancer clinics in Tehran between October and February 2018. The sample consisted of 250 patients with breast cancer who were selected by convenience sampling. Data were obtained using the Folkman and Lazarus Coping Strategies Questionnaire, the Cognitive Emotion Regulation Questionnaire (CERQ), and Morisky Medication Adherence Scale (MMAS-8). Data were also analyzed using correlation coefficients, Pearson’s correlation matrix, multiple regression, and structural equation modeling. Also, all statistical calculations were performed using Amos 22 and SPSS 22 software. Results: Emotion regulation had a direct effect on coping strategies (β=0.48, P<0.001) and adherence to treatment (β=0.63, P<0.001). Coping strategies had a mediating role in the relationship between emotion regulation and adherence to treatment (AGFI=0.98, RMSEA=0.067). Conclusion: There is a relationship between emotion regulation and adherence to treatment and coping strategies has a mediating role in women with breast cancer undergoing chemotherapy.