Efficacy of mindfulness-based stress reduction versus usual care in patients with breast cancer: a meta-analysis with trial sequential analysis of randomized controlled trials.
Jing Lei, Meimei He
Frontiers in Oncology 2026 DOI: 10.3389/fonc.2026.1780224 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Meta-analysis Randomized Peer reviewed |
|---|---|
| Sample size | 2,534 |
| Population | Patients with breast cancer at any stage |
| Intervention | Mindfulness-based stress reduction (MBSR) |
| Topics | Anxiety Depression Meditation |
| Keywords | Breast cancer Mindfulness-based stress reduction Quality of life |
| Key findings | MBSR significantly reduced anxiety (SMD -0.489), depression (SMD -0.258), and fatigue (SMD -0.399), and improved overall quality of life (SMD 0.262) compared to usual care. The 8-week protocol yielded greater benefits than the 6-week program, and effects on depression, fatigue, perceived stress, and posttraumatic growth persisted at 4 to 9 weeks post-intervention. |
Abstract
Mindfulness-based stress reduction (MBSR) has shown promise in improving physical and mental health in breast cancer patients, warranting further comprehensive evaluation. This meta-analysis aimed to assess the effects of MBSR compared to usual care on the physical and psychological well-being of patients with breast cancer. A systematic search of Web of Science, PubMed, Cochrane Library, and Embase was conducted to identify RCTs published up to October 5, 2025. Eligible studies enrolled patients with breast cancer at any stage, compared MBSR with usual care or waitlist control, and reported psychological, symptom-related, or quality of life (QoL) outcomes. Non-randomized studies, single-arm trials, duplicate reports, studies without relevant outcomes or sufficient data, and reviews, case reports, conference abstracts, letters, and animal studies were excluded. The primary outcomes were anxiety, depression, fatigue, and overall QoL. Standardized mean differences (SMDs) or mean differences (MDs) with 95% confidence intervals (CIs) were pooled according to outcome measurement scales. Heterogeneity was assessed using I2, Cochran's Q test, and 95% prediction intervals (PIs); fixed- or random-effects models were selected according to heterogeneity. Subgroup, sensitivity, and publication bias analyses were performed. Trial sequential analysis was conducted using TSA v0.9.5.10 Beta. The protocol was registered in PROSPERO (CRD420261277936). This meta-analysis included 20 studies comprising 2534 breast cancer patients. The overall results indicated that compared with usual care, MBSR significantly alleviated anxiety (SMD: -0.489, 95% CI: -0.734 to -0.244, 95% PI: -1.520 to 0.541), depression (SMD: -0.258, 95% CI: -0.347 to -0.170, 95% PI: -0.650 to 0.083), and fatigue (SMD: -0.399, 95% CI: -0.562 to -0.236, 95% PI: -0.963 to 0.166), while markedly improving overall QoL (SMD: 0.262, 95% CI: 0.059 to 0.465, 95% PI: -0.311 to 0.836). Additional benefits of MBSR included reductions in perceived stress and pain, improvements in posttraumatic growth, and decreases in total mood disturbance (all p < 0.05). Further subgroup analyses revealed that the 8-week MBSR protocol yielded more psychological and QoL improvements compared to the 6-week program. Notably, the benefits of MBSR in reducing depression, fatigue, perceived stress, and promoting posttraumatic growth remained observable at 4 to 9 weeks after the intervention (all p < 0.05), emphasizing its sustained efficacy. Our findings support MBSR as an effective intervention for improving the psychological health and QoL of breast cancer patients. Future research should focus on the long-term efficacy of MBSR in this population. https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420261277936.
Comparable studies
Other systematic reviews and meta-analyses on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Meditation Programs for Psychological Stress and Well-being Diverse adult clinical populations | 2014 | Meta-analysis | n = 3,515 |
| Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis Healthy subjects | 2009 | Systematic review and meta-analysis | |
| The psychological effects of meditation: A meta-analysis. Nonclinical groups of adult meditators | 2012 | Meta-analysis | n = 163 |
| Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse Adults with recurrent depression in full or partial remission | 2016 | Meta-analysis of individual patient data from randomized controlled trials | n = 1,258 |
| Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials | 2011 | Systematic review |
Citations in the library
Cites 24
- Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders American Journal of Psychiatry July 1, 1992
- Effects of mindfulness-based stress reduction on quality of life of breast cancer patient: A systematic review and meta-analysis. PLoS One 2024
- The use of mindfulness-based stress reduction (MBSR) for breast cancer patients-meta-analysis. BMC Psychology November 1, 2024
- Effects of Mindfulness Interventions on Anxiety, Depression, and Quality of Life in Patients Undergoing Chemotherapy for Breast Cancer: A Systematic Review and Meta‐Analysis European Journal of Cancer Care 2025
- Efficacy of Mindfulness-Based Stress Reduction for Breast Cancer (MBSR(BC)) a Treatment for Cancer-related Cognitive Impairment (CRCI): A Randomized Controlled Trial. Journal of Integrative and Complementary Medicine September 18, 2024
and 19 more in the library