Supportive Care in Cancer

, Volume 27, Issue 3, pp 771–781 | Cite as

Effectiveness of mindfulness-based stress reduction (MBSR) on symptom variables and health-related quality of life in breast cancer patients—a systematic review and meta-analysis

  • Qiuxiang Zhang
  • Heng Zhao
  • Yaning ZhengEmail author
Review Article



The purpose of this systematic review and meta-analysis was to evaluate the effectiveness of mindfulness-based stress reduction (MBSR) in breast cancer patients.


A systematic search of Cochrane Library, Cochrane Central Register of Controlled Trials, PsycINFO database, Web of science, Medline, EMBASE, CNKI, and CBM database was carried out from February to May 2018, with no language restrictions. Trials examining the effects of MBSR versus control group on symptom variables and health-related quality of life were included. Data concerning studies, patient characteristics, and outcomes were extracted. Methodological quality of each included randomized controlled trials were assessed individually by two reviewers independently using criteria recommended in the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. Meanwhile, Newcastle-Ottawa Quality Assessment Scale (NOS) was used to evaluate methodological quality of non-randomized studies.


In all, 14 studies involving 1505 participants were included. Due to the effect of MBSR, statistically significant results were found on physiological function (SMD = 0.28, 95% CI [0.07, 0.049], P = 0.008), cognitive function (SMD = 1.48, 95% CI [0.34, 2.61], P = 0.01), fatigue (SMD = − 0.66, 95% CI [− 1.11, − 0.20], P = 0.004), emotional wellbeing (SMD = 1.01, 95% CI [0.35, 1.67], P = 0.003), anxiety (SMD = − 0.54, 95% CI [− 1.01, − 0.07], P = 0.02), depression (SMD = − 0.61, 95% CI [− 1.11, − 0.11], P = 0.02), stress (SMD = − 0.48, 95% CI [− 0.81, − 0.15], P = 0.004), distress (SMD = − 0.56, 95% CI [− 0.85, − 0.26], P = 0.0002) and mindfulness (SMD = 0.94, 95% CI [0.10, 1.79], P = 0.03). Although the effects on pain, sleep quality, and global QoL were in the expected direction, they were not statistically significant (P > 0.05) based on insufficient evidence.


MBSR is worthy of being recommended to breast cancer patients as a complementary treatment or adjunctive therapy.


Mindfulness-based stress reduction Breast cancer Health-related quality of life Meta-analysis 


Funding information

This work is funded by grants from the National clinical key specialist nursing project of China (2011872) and nursing research fund of the Affiliated Hospital of Nanjing University (ZSC530).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Nursing, The Affiliated Hospital of Nanjing UniversityNanjing Drum Tower HospitalNanjingChina

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