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Mindfulness-based interventions for women with breast cancer: an updated systematic review and meta-analysis.

Acta oncologica (Stockholm, Sweden)
December 1, 2017
Heidemarie Haller et al. (6 authors)
Journal ArticleMeta-AnalysisReviewSystematic ReviewHuman Study
Study Details

Study Goal

The researchers aimed to update the evidence for mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) in improving health-related quality of life and psychological outcomes in women with breast cancer.

Results Summary

The meta-analysis found significant short-term improvements in health-related quality of life, fatigue, sleep, stress, anxiety, and depression post-intervention, though effects were below clinically meaningful thresholds. Effects for anxiety and depression persisted up to 12 months, but clinical relevance remained unclear.

Population

Women with breast cancer (1,709 participants across 10 studies).

Effective Dosage

Not specified

Duration

Post-intervention effects assessed; follow-up up to 12 months.

Interactions

None mentioned

Extracted Claims (12)
InterventionDirectionEndpointPopulationDosageImpactClaim #
mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT)
increase
health-related quality of life
women with breast cancer
SMD = .21; 95%CI = [.04-.39]
significant post-intervention effects
#1
mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT)
decrease
fatigue
women with breast cancer
SMD = -.28; 95%CI = [-.43 to -.14]
significant post-intervention effects
#2
mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT)
decrease
sleep
women with breast cancer
SMD = -.23; 95%CI = [-.40 to -.05]
significant post-intervention effects
#3
mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT)
decrease
stress
women with breast cancer
SMD = -.33; 95%CI = [-.61 to -.05]
significant post-intervention effects
#4
mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT)
decrease
anxiety
women with breast cancer
SMD = -.28; 95%CI = [-.39 to -.16]
significant post-intervention effects
#5
mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT)
decrease
depression
women with breast cancer
SMD = -.34; 95%CI = [-.46 to -.21]
significant post-intervention effects
#6
mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT)
decrease
anxiety
women with breast cancer
SMD = -.28; 95%CI = [-.47 to -.09]
significant effects up to 6 months after baseline
#7
mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT)
decrease
depression
women with breast cancer
SMD = -.26; 95%CI = [-.47 to -.04]
significant effects up to 6 months after baseline
#8
mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT)
decrease
anxiety
women with breast cancer
SMD = -.21; 95%CI = [-.40 to -.03]
significant effects up to 12 months after baseline
#9
mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT)
decrease
anxiety
women with breast cancer
SMD = -.45; 95%CI = [-.71 to -.18]
significant effects post-intervention compared to other active interventions
#10
mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT)
decrease
depression
women with breast cancer
SMD = -.39; 95%CI = [-.65 to -.14]
significant effects post-intervention compared to other active interventions
#11
mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT)
neutral
-
women with breast cancer
-
short-term effectiveness and safety
#12
Abstract

BACKGROUND: The aim of this meta-analysis was to systematically update the evidence for mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) in women with breast cancer. MATERIAL AND METHODS: In October 2016, PubMed, Scopus, and Central were searched for randomized controlled trials on MBSR/MBCT in breast cancer patients. The primary outcome was health-related quality of life. Secondary outcomes were fatigue, sleep stress, depression, anxiety, and safety. For each outcome, standardized mean differences (SMD/Hedges' g) and 95% confidence intervals (CI) were calculated. Risk of bias was assessed by the Cochrane risk of bias tool. RESULTS: The Literature search identified 14 articles on 10 studies that included 1709 participants. The overall risk of bias was unclear, except for risk of low attrition bias and low other bias. Compared to usual care, significant post-intervention effects of MBSR/MBCT were found for health-related quality of life (SMD = .21; 95%CI = [.04-.39]), fatigue (SMD = -.28; 95%CI = [-.43 to -.14]), sleep (SMD = -.23; 95%CI = [-.40 to -.05]), stress (SMD = -.33; 95%CI = [-.61 to -.05]), anxiety (SMD = -.28; 95%CI = [-.39 to -.16]), and depression (SMD = -.34; 95%CI = [-.46 to -.21]). Up to 6 months after baseline effects were significant for: anxiety (SMD = -.28; 95%CI = [-.47 to -.09]) and depression (SMD = -.26; 95%CI = [-.47 to -.04]); and significant for anxiety (SMD = -.21; 95%CI = [-.40 to -.03]) up to 12 months after baseline. Compared to other active interventions, significant effects were only found post-intervention and only for anxiety (SMD = -.45; 95%CI = [-.71 to -.18]) and depression (SMD = -.39; 95%CI = [-.65 to -.14]). However, average effects were all below the threshold of minimal clinically important differences. Effects were robust against potential methodological bias. Adverse events were insufficiently reported. CONCLUSIONS: This meta-analysis revealed evidence for the short-term effectiveness and safety of mindfulness-based interventions in women with breast cancer. However, their clinical relevance remains unclear. Further research is needed.

Medical Subject Headings (MeSH)
AnxietyBreast NeoplasmsCognitive Behavioral TherapyDepressionFatigueFemaleHealth StatusHumansMindfulnessQuality of LifeSleep Initiation and Maintenance DisordersSleep Wake Disorders
Study Links
Quality Scores
Safety70
Efficacy65/10
Quality80/10
Citation Metrics
Total Citations165
Citations/Year20.6
Relative Citation Ratio8.29
NIH Percentile97%
Research Impact Scores
APT Score0.95
Weight Score2.31
Normalized Score0.70
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