Abstract
Background
Psychological issue is the most common co-morbidity of women with breast cancer (BC) after receiving treatment. Effective coping with this problem is significant importance. The aim of this meta-analysis is to evaluate the benefits of mindfulness-based stress reduction (MBSR) on psychological distress among breast cancer survivors.
Methods
PUBMED, EMBASE, and the Cochrane Central Register of Controlled Trials were systematically searched from their inception to June 30, 2014. Two reviewers independently reviewed and extracted the data. The primary outcomes of interest were psychological domains. Review Manager 5.3 was used to pool collected data.
Results
Nine articles involving 964 participants were identified. Compared with those in control group, patients in MBSR group have a significant improvement on psychological domains: depression [mean difference (MD), 5.09; 95 % confidence interval (CI), 3.63–6.55; P < 0.00001], anxiety (MD, 2.79; 95 % CI, 1.62–3.96; P < 0.00001), stress (MD, 4.10; 95 % CI, 2.46–5.74; P < 0.00001). MBSR can also improve the overall quality of life (QOL) (MD, −1.16; 95 % CI, −2.21 to −0.12; P = 0.03).
Conclusions
On the basis of our findings, MBSR shows a positive effect on psychological function and QOL of breast cancer survivors. This approach can be recommended to breast cancer patients as a part of their rehabilitation.
This is a preview of subscription content, access via your institution.





References
Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69–90.
Mistry M, Parkin DM, Ahmad AS, Sasieni P. Cancer incidence in the United Kingdom: projections to the year 2030. Br J Cancer. 2011;105(11):1795–803.
Pinto AC, de Azambuja E. Improving quality of life after breast cancer: dealing with symptoms. Maturitas. 2011;70(4):343–8.
Gregurek R, Bras M, Dordević V, Ratković AS, Brajković L. Psychological problems of patients with cancer. Psychiatr Danub. 2010;22(2):227–30.
Zainal NZ, Nik-Jaafar NR, Baharudin A, Sabki ZA, Ng CG. Prevalence of depression in breast cancer survivors: a systematic review of observational studies. Asian Pac J Cancer Prev. 2013;14(4):2649–56.
Pumo V, Milone G, Iacono M, Giuliano SR, Di Mari A, Lopiano C, et al. Psychological and sexual disorders in long-term breast cancer survivors. Cancer Manag Res. 2012;4:61–5.
Satin JR, Linden WF, Phillips MJ. Depression as a predictor of disease progression and mortality in cancer patients: a meta-analysis. Cancer. 2009;115(22):5349–61.
Giese-Davis J, Collie K, Rancourt KM, Neri E, Kraemer HC, Spiegel D. Decrease in depression symptoms is associated with longer survival in patients with metastatic breast cancer: a secondary analysis. J Clin Oncol. 2011;29(4):413–20.
Kabat-Zinn J. Influence of a mindfulness meditation based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA). Psychosom Med. 1998;60(5):625–32.
Shennan C, Payne S, Fenlon D. What is the evidence for the use of mindfulness-based interventions in cancer care? A review. Psychooncology. 2011;20(7):681–97.
Ledesma D, Kumano H. Mindfulness-based stress reduction and cancer: a meta-analysis. Psychooncology. 2009;18(6):571–9.
Pierce WC, Figlin RA. Mindfulness-based stress reduction for breast cancer—a systematic review and meta-analysis. Curr Oncol. 2012;19(5):343–52.
Hoffman CJ, Ersser SJ, Hopkinson JB, Nicholls PG, Harrington JE, Thomas PW. Effectiveness of mindfulness-based stress reduction in mood, breast- and endocrine-related quality of life, and well-being in stage 0 to III breast cancer: a randomized, controlled trial. J Clin Oncol. 2012;30(12):1335–42.
Würtzen H, Dalton SO, Elsass P, Sumbundu AD, Steding-Jensen M, Karlsen RV, et al. Mindfulness significantly reduces self-reported levels of anxiety and depression: results of a randomized controlled trial among 336 Danish women treated for stage I-III breast cancer. Eur J Cancer. 2013;49(6):1365–73.
Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group: preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Int Med. 2009;151(4):264–9.
Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. URL: http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm. Accessed 10 Dec 2014.
Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. Br Med J. 2003;327(7414):557–60.
Sterne JA, Sutton AJ, Ioannidis JP, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. Br Med J. 2011;342:d4002.
Dobkin PL. Mindfulness-based stress reduction: what processes are at work? Complement Ther Clin Pract. 2008;14(1):8–16.
Henderson VP, Clemow L, Massion AO, Hurley TG, Druker S, Hébert JR. The effects of mindfulness-based stress reduction on psychosocial outcomes and quality of life in early-stage breast cancer patients: a randomized trial. Breast Cancer Res Treat. 2012;131(1):99–109.
Lengacher CA, Johnson-Mallard V, Post-White J, Moscoso MS, Jacobsen PB, Klein TW, et al. Randomized controlled trial of mindfulness-based stress reduction (MBSR) for survivors of breast cancer. Psycho-oncology. 2009;18(12):1261–72.
Lengacher CA, Johnson-Mallard V, Barta M, Fitzgerald S, Moscoso MS, Post-White J, et al. Feasibility of a mindfulness-based stress reduction program for early-stage breast cancer survivors. J Holist Nurs. 2011;29(2):107–17.
Matchim Y, Armer JM, Stewart BR. Effects of mindfulness-based stress reduction (MBSR) on health among breast cancer survivors. West J Nurs Res. 2011;33(8):996–1016.
Matousek RH, Dobkin PL. Weathering storms: a cohort study of how participation in a mindfulness-based stress reduction program benefits women after breast cancer treatment. Curr Oncol. 2010;17(4):62–70.
Matousek RH, Pruessner JC, Dobkin PL. Changes in the cortisol awakening response (CAR) following participation in mindfulness-based stress reduction in women who completed treatment for breast cancer. Complement Ther Clin Pract. 2011;17(2):65–70.
Witek-Janusek L, Gabram S, Mathews HL. Psychological stress, reduced NK cell activity, and cytokine dysregulation in women experiencing diagnostic breast biopsy. Psychoneuroendocrinology. 2007;32(1):22–35.
Carlson LE, Ursalick Z, Goodey E, Angen M, Speca M. The effects of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients: 6-month follow-up. Support Care Cancer. 2001;9(2):112–23.
Kvillemo P, Bränström R. Experiences of a mindfulness-based stress-reduction intervention among patients with cancer. Cancer Nurs. 2011;34(1):24–31.
Montazeri A, Vahdaninia M, Harirchi I, Ebrahimi M, Khaleghi F, Jarvandi S. Quality of life in patients with breast cancer before and after diagnosis: an eighteen months follow-up study. BMC Cancer. 2008;8:330.
Loerzel VW, McNees P, Powel LL, Su X, Meneses K. Quality of life in older women with early-stage breast cancer in the first year of survivorship. Oncol Nurs Forum. 2008;35(6):924–32.
Schou I, Ekeberg Ø, Sandvik L, Hjermstad MJ, Ruland CM. Multiple predictors of health-related quality of life in early stage breast cancer. Data from a year follow-up study compared with the general population. Qual Life Res. 2005;14(8):1813–23.
Lerman R, Jarski R, Rea H, Gellish R, Vicini F. Improving symptoms and quality of life of female cancer survivors: a randomized controlled study. Ann Surg Oncol. 2012;19(2):373–8.
Carlson LE, Speca M, Patel KD, Goodey E. Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Psychosom Med. 2003;65(4):571–81.
Witek-Janusek L, Albuquerque K, Chroniak KR, Chroniak C, Durazo-Arvizu R, Mathews HL. Effect of mindfulness based stress reduction on immune function, quality of life and coping in women newly diagnosed with early stage breast cancer. Brain Behav Immun. 2008;22(6):969–81.
Roemer L, Orsillo SM. Mindfulness: a promising intervention strategy in need of further study. Clin Psychol Sci Pract. 2003;10(2):172–8.
Shapiro SL, Bootzin RR, Figueredo AJ, Lopez AM, Schwartz GE. The efficacy of mindfulness-based stress reduction in the treatment of sleep disturbance in women with breast cancer: an exploratory study. J Psychosom Res. 2003;54(1):85–91.
Acknowledgments
All authors wish to thank the professor Zhou, JR for her kind suggestions. No potential conflicts of interest were disclosed.
Author information
Authors and Affiliations
Corresponding author
Additional information
A protocol was registered on PROSPERO (the international register of systematic reviews; registration number: CRD42014009409).
About this article
Cite this article
Huang, Hp., He, M., Wang, Hy. et al. A meta-analysis of the benefits of mindfulness-based stress reduction (MBSR) on psychological function among breast cancer (BC) survivors. Breast Cancer 23, 568–576 (2016). https://doi.org/10.1007/s12282-015-0604-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12282-015-0604-0
Keywords
- Breast cancer
- Mindfulness-based stress reduction
- Psychological
- Quality of life
- Meta-analysis