Objective To explore the trajectory of postoperative nutritional literacy changes in breast cancer patients and analyses the influencing factors of different trajectories. Method 450 breast cancer patients admitted to Yuncheng Central Hospital Shanxi Medical University from April 2022 to January 2024 were selected as the study subjects and the basic information questionnaire and the nutritional literacy questionnaire were used to conduct questionnaire surveys in the postoperative period T1 one month after operation T2 three months after operation T3 and six months after operation T4 respectively. The latent category growth model and one-way analysis of variance were used for data analysis and testing. Result In this study 450 questionnaires were initially distributed and 412 valid consecutive questionnaires were completed for the four time points with a recovery rate of 91. 56%. The scores of surgical nutrition literacy in breast cancer patients were 19. 31±5. 33 21. 67±5. 26 23. 07±5. 49 23. 22±5. 21 respectively. There were three different tracks of nutritional literacy and the average probabilities were 0. 962 0. 958 and 0. 960 respectively. The 3 trajectory categories were medium literacy increase group 47. 1% higher literacy smooth group 29. 1% and lower literacy smooth group 23. 8% . Different trajectory categories were found in age χ 2 = 8. 870 P = 0. 012 marital status χ 2 = 8. 210 P = 0. 016 educational level χ 2 = 26. 061 P < 0. 001 mode of residence χ 2 = 8. 886 P = 0. 012 BMI index χ 2 = 24. 959 P < 0. 001 preoperative radiotherapy χ 2 = 10. 298 P = 0. 006 were significantly different. Logistic regression showed that <60 years old married educational level secondary school and above and BMI > 18. 5 kg / m 2 became protective factors for nutritional literacy in breast cancer patients and living alone and preoperative radiotherapy became risk factors P < 0. 05 . Conclusion In this study three types of trajectories of nutrient literacy were identified by investigating the changing characteristics of postoperative nutrient literacy in breast cancer patients. Patients in different nutrient literacy groups and are affected by a combination of age marriage education level mode of residence BMI and preoperative radiotherapy etc. It is important to pay attention to the assessment of the level of postoperative nutrient literacy of breast cancer patients especially those in the lower literacy smoother group and timely nutritional knowledge education and necessary nutritional interventions and support to improve their nutritional status in the later stage of the disease.