Objective To systematically integrate qualitative research on experience of altered body image and dyadic coping in breast cancer couples, and to provide evidence-based references for future intervention programs.Methods Qualitative studies on the experiences of body image in breast cancer patients and their spouses were searched in Chinese and English databases. The quality of the literature was evaluated using the 2016 edition of JBI Evidence-Based Health Care Center quality evaluation criteria for qualitative studies. The results were summarized and integrated by meta-aggregative approach. Results A total of 45 results were extracted from 20 studies, which were summarized into 8 categories and 3 conclusions. According to the time course, breast cancer couples experienced three stages of treatment-related physical changes:confusion period-physical changes make the couple suffer from shock and poor communication; stress period-couples actively compensate for physical defects, and cope well; stable period-the couple′s attention to the body tends to be settled, and the couple′s relationship is stable or deteriorated. Conclusion The couples with breast cancer have experienced confusion, stress and stability. Medical staff should pay attention to patient experience related to altered appearance and conduct dyadic interventions in the diagnosis, treatment and rehabilitation, to help them better cope with the body image problem.