Journal of Behavioral Medicine

, Volume 37, Issue 2, pp 185–195 | Cite as

Mindfulness based stress reduction (MBSR(BC)) in breast cancer: evaluating fear of recurrence (FOR) as a mediator of psychological and physical symptoms in a randomized control trial (RCT)

  • Cecile A. LengacherEmail author
  • Melissa M. Shelton
  • Richard R. Reich
  • Michelle K. Barta
  • Versie Johnson-Mallard
  • Manolete S. Moscoso
  • Carly Paterson
  • Sophia Ramesar
  • Pinky Budhrani
  • Irina Carranza
  • Jean Lucas
  • Paul B. Jacobsen
  • Matthew J. Goodman
  • Kevin E. Kip


To investigate the mechanism(s) of action of mindfulness based stress reduction (MBSR(BC)) including reductions in fear of recurrence and other potential mediators. Eighty-two post-treatment breast cancer survivors (stages 0–III) were randomly assigned to a 6-week MBSR(BC) program (n = 40) or to usual care group (UC) (n = 42). Psychological and physical variables were assessed as potential mediators at baseline and at 6 weeks. MBSR(BC) compared to UC experienced favorable changes for five potential mediators: (1) change in fear of recurrence problems mediated the effect of MBSR(BC) on 6-week change in perceived stress (z = 2.12, p = 0.03) and state anxiety (z = 2.03, p = 0.04); and (2) change in physical functioning mediated the effect of MBSR(BC) on 6-week change in perceived stress (z = 2.27, p = 0.02) and trait anxiety (z = 1.98, p = 0.05). MBSR(BC) reduces fear of recurrence and improves physical functioning which reduces perceived stress and anxiety. Findings support the beneficial effects of MBSR(BC) and provide insight into the possible cognitive mechanism of action.


Fear of recurrence Cancer Mindfulness-based stress reduction (MBSR) Oncology 



Supported by the National Institutes of Health, National Cancer Institute: grant number R21CA109168.

Conflict of interest

The authors have no conflicts to report.


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Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Cecile A. Lengacher
    • 1
    Email author
  • Melissa M. Shelton
    • 1
  • Richard R. Reich
    • 2
  • Michelle K. Barta
    • 1
  • Versie Johnson-Mallard
    • 1
  • Manolete S. Moscoso
    • 1
  • Carly Paterson
    • 1
  • Sophia Ramesar
    • 1
  • Pinky Budhrani
    • 1
  • Irina Carranza
    • 1
  • Jean Lucas
    • 1
  • Paul B. Jacobsen
    • 2
  • Matthew J. Goodman
    • 3
  • Kevin E. Kip
    • 1
  1. 1.University of South Florida College of NursingTampaUSA
  2. 2.H. Lee Moffitt Cancer Center and Research InstituteTampaUSA
  3. 3.Department of Clinical MedicineUniversity of VirginiaCharlottesvilleUSA

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