Targeting Depressive Symptoms in Younger Breast Cancer Survivors: The Pathways to Wellness Randomized Controlled Trial of Mindfulness Meditation and Survivorship Education.
Julienne E Bower, Ann H Partridge, Antonio C Wolff, Elissa D Thorner, Michael R. Irwin, Hadine Joffe, Laura Petersen, Catherine M Crespi, Patricia A Ganz
Journal of Clinical Oncology November 1, 2021 DOI: 10.1200/jco.21.00279 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 247 |
| Population | Younger breast cancer survivors diagnosed at or before age 50 who had completed treatment and had elevated depressive symptoms (median age 46 years) |
| Interventions | Mindful awareness practices (MAPs) survivorship education (SE) |
| Duration | 6-week intervention with assessments preintervention, postintervention, and 3-month and 6-month postintervention follow-ups |
| Measures | Center for Epidemiologic Studies-Depression Scale |
| Topics | Meditation |
| Registration | NCT03025139 |
| Key findings | Mindful awareness practices and survivorship education both reduced depressive symptoms in younger breast cancer survivors relative to a wait-list control after 6 weeks. The benefit of mindful awareness practices persisted at 6-month follow-up, and only mindful awareness practices also improved fatigue, insomnia, and vasomotor symptoms at 6 months. |
Abstract
Younger women are at risk for depression and related symptoms following breast cancer. The Pathways to Wellness study, a randomized, multi-institution, three-arm trial, tested the efficacy of two behavioral interventions for younger breast cancer survivors with elevated depressive symptoms: mindful awareness practices (MAPs) and survivorship education (SE) (Clincaltrials.gov identifier: NCT03025139). Women diagnosed with breast cancer at or before 50 years of age who had completed treatment and had elevated depressive symptoms were randomly assigned to 6 weeks of MAPs, SE, or wait-list control (WLC). Assessments were conducted preintervention and postintervention and at 3-month and 6-month postintervention follow-ups. Analyses compared each intervention to WLC using linear mixed models. The primary outcome was change in depressive symptoms from preintervention to postintervention on the Center for Epidemiologic Studies-Depression Scale; secondary outcomes included change in fatigue, insomnia, and vasomotor symptoms. Two hundred forty-seven women (median age = 46 years) were randomly assigned to MAPs (n = 85), SE (n = 81), or WLC (n = 81). MAPs and SE led to significant decreases in depressive symptoms from preintervention to postintervention relative to WLC (mean change relative to WLC [95% CI]: MAPs, -4.7 [-7.5 to -1.9]; SE, -4.0 [-6.9 to -1.1]), which persisted at 6-month follow-up for MAPs (mean change relative to WLC [95% CI]: MAPs, -3.7 [-6.6 to -0.8]; SE, -2.8 [-5.9 to 0.2]). MAPs, but not SE, also had beneficial effects on fatigue, insomnia, and vasomotor symptoms that persisted at 6-month follow-up (P < .05). Mindfulness meditation and SE reduced depressive symptoms in younger breast cancer survivors. These interventions can be widely disseminated over virtual platforms and have significant potential benefit for quality of life and overall survivorship in this vulnerable group.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 19
- Effects of Mindfulness-Based Interventions on Depression in Patients With Breast Cancer: A Systematic Review and Meta-Analysis. Integrative Cancer Therapies 2023
- A Randomized Controlled Trial of Mindfulness Meditation Combined With BrainLink Intelligent Biofeedback Instrument on Pancreatic Cancer Patients Under Chemotherapy. Brain and Behavior December 1, 2024
- Effectiveness of an online mindfulness-based stress-reduction intervention to reduce anxiety in breast cancer survivors: a randomized-controlled trial. Supportive Care in Cancer June 24, 2025
- Global landscape and hotspot analysis of meditation research in cancer: a bibliometric study. Journal of Cancer Survivorship April 5, 2025
- Mediators of a Mindfulness-Based Intervention for Younger Breast Cancer Survivors: Effects on Depressive Symptoms. Psychosomatic Medicine October 1, 2024
and 14 more in the library