Remotely-Delivered Cognitive Behavioral Stress Management for Breast Cancer (R-CBSM)

Inclusion Criteria: * 50 yrs or older * Speaks and reads English or Spanish at 6th grade level * Diagnosed and completed primary treatment for Stage I-III HR + estrogen/ progesterone + (ER/PR) * Human Epidermal Growth Factor Receptor 2 (Her2neu)- breast cancer 3 - 12 months prior * Post-menopausal (\> 12 months since last menstrual cycle) * Elevated distress (Impact of Event Scale-intrusive thoughts \[IES-I\] \> 14 or elevated distress based on assessment of PI * If prescribed anti-depressants or anxiolytics on similar regimen \> 2 months. * Undergoing treatment with Adjuvant Endocrine Therapy (AET) * Participants may or may not have received chemotherapy or radiation during primary treatment Exclusion Criteria: * Unable or unwilling to provide informed consent * Diagnosis with metastatic disease, HER2neu+ or Triple Negative breast cancer * Prior cancer diagnosis (with the exception of non-melanoma skin cancer) in the 2 years prior to the current breast cancer diagnosis * Active untreated major mental illness (e.g., schizophrenia, psychosis, bi-polar, substance abuse, panic disorder, PTSD diagnosis), * Acute or chronic co-morbid medical condition with known effects on the immune system (e.g., HIV infection, autoimmune diseases such as Lupus, Rheumatoid Arthritis, Acute or Chronic Hepatitis, and Multiple Sclerosis, Graves' Disease, Chronic Fatigue Syndrome, Fibromyalgia etc.). example: history of heart disease, e.g., past stroke, myocardial infarction (MI), or congestive heart failure are not exclusionary. * Significant cognitive impairment, \<32 on the Telephone Interview for Cognitive Status (TICS) * Receipt of immunotherapy as part of treatment