The diagnosis and treatment of breast cancer cause significant psychological distress in patients. Nurse-led holistic and creative care approaches play a crucial role in supporting cognitive and emotional coping. This case report examines changes in coping, depression, anxiety, and stress following a nurse-led visual-aided flower imagery supportive intervention in two breast cancer patients receiving hormone therapy. The two cases were purposively selected to represent contrasting points on the illness trajectory (a long-term survivor with recurrence versus a recently diagnosed patient), enabling examination of how the same intervention operates across different illness phases. The intervention was conducted online in a single 25-30 minute session. The participants were assessed using the Turkish versions of the Cognitive Emotional Coping with Cancer Scale (CECC) and Depression Anxiety Stress Scale-21 (DASS-21) before the intervention. Nine AI-generated flower visuals were presented, and patients selected the flower best representing them. Semi-structured questions explored symbolic meanings related to their illness experience. The CECC was re-administered immediately after, and the DASS one week later. Qualitative data were analyzed thematically, revealing four themes: symbolic transformation of the illness experience, emergence of inner strength and resilience, indirect expression of unspoken emotions, and psychological anchor. The findings suggest nurse-led imagery-based supportive interventions may effectively support emotional expression, cognitive awareness, and coping in oncology nursing care.