In light of the rapid evolvements in breast cancer treatment in recent decades, doctors and patients need to weigh the potential risks against the likely benefits when making treatment decisions. There is evidence of a substantial amount of underappreciated medium- and long-term morbidity associated with breast cancer treatment. A cross-sectional cohort study was conducted to determine the prevalence and severity of persistent functional decrements and symptoms experienced by breast cancer survivors and in doing so, identify variables associated with poorer health-related quality of life (HRQoL) outcomes. 400 English-speaking women treated for DCIS or stage I-III breast cancer between 1999 and 2009, at least 12 months after surgery and currently disease free were randomly selected and invited to complete 1) the Breast Cancer Treatment Outcome Scale (BCTOS) and 2) European Organization for Research and Treatment of Cancer (EORTC) core Quality of Life Questionnaire (QLQ-C30). The response rate was 85.60%. Moderate to severe decrements in HRQoL domains including functional wellbeing (15%), cosmetic status (32%) and overall quality of life (21%) were found. There were strong associations (all p<0.05) between younger age and poorer HRQoL. There were no significant associations between time since surgery and morbidity (all p>0.05). Those with higher stage disease had poorer scores in both cosmetic status and breast specific pain. Different treatments were associated with different impacts on the participants’ HRQoL. Patients who had undergone axillary dissection reported poorer functional status when compared to those who had sentinel node biopsy or no axillary surgery (p<0.05). Adjuvant radiotherapy was a significant predictor of breast specific pain (p<0.05). Apart from poorer perceptions of body image (p<0.05), patients who had undergone mastectomy reported a similar level of HRQoL compared to those who had breast conserving surgery. Overall, a significant proportion of breast cancer survivors have long-term physical morbidity. Significant association between locoregional therapies and poorer HRQoL outcomes stress the importance of tailoring locoregional therapy.