Breast cancer is one of the leading causes of morbidity and mortality among women. A diagnosis of cancer is a stressful event that requires an individual to adapt to new stressors. The purpose of this qualitative study was to better understand the perceptions of mana'olana/hope and living with breast cancer among Native Hawaiian women. The conceptual framework of this phenomenological study was positive psychology. Data collection included in-depth interviews with 5 Native Hawaiian women who had been diagnosed with breast cancer. Data coding and analysis resulted in identification of 8 themes. The themes included: (a) mana'olana /hope is the essence of my being, (b) family strengthens me and gave me mana'olana/hope, (c) my relationship with God and Jesus promoted mana'olana/hope in me, (d) my religious affiliation promoted mana'olana/hope in me, (e) the cancer support group promoted mana'olana/hope in me, (f) the cancer treatment team promoted mana'olana/hope in me, (g) treatment options; Allopathic, Osteopathic, Naturopathic, Alternative medicine, and herbal remedies promoted mana'olana/hope in me, and (h) nature's beauty and the arts promoted mana'olana/hope in me. Results may be used by health psychologists, cancer treatment practitioners, and the field of biobehavioral oncology to support and improve the well-being and health outcomes of women diagnosed with breast cancer.