Randomized controlled trial of mindfulness‐based stress reduction (MBSR) for survivors of breast cancer

TLDR

Considerable morbidity persists among survivors of breast cancer, including high levels of psychological stress, anxiety, depression, fear of recurrence, physical symptoms such as pain, fatigue, sleep disturbances, and impaired quality of life. We conducted a randomized controlled trial of 84 female breast cancer survivors to evaluate the effectiveness of a 6‑week Mindfulness‑Based Stress Reduction program during the transitional period after treatment. Participants, all within 18 months of completing surgery and adjuvant therapy, were randomized to either the MBSR program or usual care. Compared with usual care, MBSR participants showed significantly lower depression, anxiety, and fear of recurrence scores and higher energy, physical functioning, and physical role functioning at 6 weeks, with greater improvements among more compliant participants.

Abstract

Considerable morbidity persists among survivors of breast cancer (BC) including high levels of psychological stress, anxiety, depression, fear of recurrence, and physical symptoms including pain, fatigue, and sleep disturbances, and impaired quality of life. Effective interventions are needed during this difficult transitional period.We conducted a randomized controlled trial of 84 female BC survivors (Stages 0-III) recruited from the H. Lee Moffitt Cancer and Research Institute. All subjects were within 18 months of treatment completion with surgery and adjuvant radiation and/or chemotherapy. Subjects were randomly assigned to a 6-week Mindfulness-Based Stress Reduction (MBSR) program designed to self-regulate arousal to stressful circumstances or symptoms (n=41) or to usual care (n=43). Outcome measures compared at 6 weeks by random assignment included validated measures of psychological status (depression, anxiety, perceived stress, fear of recurrence, optimism, social support) and psychological and physical subscales of quality of life (SF-36).Compared with usual care, subjects assigned to MBSR(BC) had significantly lower (two-sided p<0.05) adjusted mean levels of depression (6.3 vs 9.6), anxiety (28.3 vs 33.0), and fear of recurrence (9.3 vs 11.6) at 6 weeks, along with higher energy (53.5 vs 49.2), physical functioning (50.1 vs 47.0), and physical role functioning (49.1 vs 42.8). In stratified analyses, subjects more compliant with MBSR tended to experience greater improvements in measures of energy and physical functioning.Among BC survivors within 18 months of treatment completion, a 6-week MBSR(BC) program resulted in significant improvements in psychological status and quality of life compared with usual care.