Purpose <p>Breast cancer treatments cause hormonal and sexual alterations that can leave physical and psychological sequelae. The purpose of this study is to establish the incidence of pelvic floor dysfunction (PFD) in female breast cancer survivors and its relationship with the cancer treatment received, as well as the impact on quality of life.</p> Methods <p>We conducted a matched cross-sectional observational study involving 150 female breast cancer survivors from Alicante (Spain) and 287 age-matched women as a control group. Demographic, anthropometric, obstetric, and lifestyle habits data were collected for all participants, and data related to breast cancer were additionally collected for breast cancer survivors. The Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7) were included.</p> Results <p>A greater number of breast cancer survivors had menopause compared to the control group. When selecting only participants with menopause, cancer survivors were younger than the control group females with menopause. A higher prevalence of urinary incontinence, pelvic organ prolapse, and flatus incontinence was observed in cancer survivors. Breast cancer survivors presented more PFD symptoms and a greater negative impact on quality of life. Treatment with chemotherapy, radiotherapy, and hormone therapy had a greater negative impact on pelvic function.</p> Conclusions <p>The early onset of menopause among breast cancer survivors has a negative impact on pelvic function and quality of life. The association of this symptomatology with the type of cancer treatment received suggests the need to assess and monitor pelvic function from the time of cancer diagnosis and treatment.</p>