In a consecutive sample of 100 breast cancer patients undergoing radiotherapy, cancer-related distress was assessed with the Hospital Anxiety and Depression Scale and patients' interest in and acceptance of psychosocial support with the Questionnaire for Psychosocial Support and the European Consultation Liaison Workgroup documentation form. 31% of the patients suffered moderate to severe anxiety and/or depression and 42% expressed interest in supportive counselling. The wish for psychosocial support did not correlate with distress (moderate or severe anxiety and/or depression; Kappa = 0.06; P = 0.560). Patients with elevated levels of distress and/or those expressing a wish for psychosocial support were offered counselling by a psychotherapist and a social worker within the framework of a liaison service; 69% of the 58 patients offered such support accepted it. We conclude that screening instruments are helpful in identifying and consequently offering support to patients in need of counselling. Copyright © 2004 John Wiley & Sons, Ltd.