Haller, H., Winkler, M.M., Klose, P., Dobos, G., Kummel, S., & Cramer, H. (2017). Mindfulness-based interventions for women with breast cancer: An updated systematic review and meta-analysis. Acta Oncologica, 56, 1665–1676.
STUDY PURPOSE: To systematically review the evidence for mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) for women with breast cancer.
TYPE OF STUDY: Meta-analysis and systematic review
DATABASES USED: PubMed, MEDLINE, Scopus, Embase, Central
YEARS INCLUDED: No restrictions for time
INCLUSION CRITERIA: Randomized controlled trials, adults with breast cancer, MBSR or MBCT or variations of each
EXCLUSION CRITERIA: Heterogeneous cancer populations (unless data for breast cancer were reported separately), interventions that were clearly different from MBSR or MBCT
TOTAL REFERENCES RETRIEVED: 608 in initial search, 14 in final analyses
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Appropriate
FINAL NUMBER STUDIES INCLUDED: 14 articles on 10 studies
TOTAL PATIENTS INCLUDED IN REVIEW: 1,709
SAMPLE RANGE ACROSS STUDIES: 44–336
KEY SAMPLE CHARACTERISTICS: Women with mostly nonmetastatic breast cancer, during and after treatment, stage 0–4; mean age ranged from 46.1–58.0 years
PHASE OF CARE: Multiple phases of care
Small short-term benefit for MBSR or MBCT on health-related quality of life compared to usual care (p = 0.020); the same was found for fatigue (p < 0.00), sleep (p = 0.001), and depression (p < 0.001). Sleep was assessed with the MOS-Ss and the PSQI as well as the sleep subscale of the MDASI. Anxiety outcomes were not included in the meta-analysis.
This was a well-conducted systematic review that identified preliminary evidence that MBSR and MBCT are safe and show short-term effectiveness for quality of life, fatigue, sleep, stress, anxiety, and depression in women with breast cancer. Clinical relevance remains unclear, and future studies should include longer follow-up and more active control conditions.
MBSR and MBCT show promise for symptom management in women with breast cancer, but more evidence is needed prior to widespread implementation.