Lengacher, C.A., Johnson-Mallard, V., Post-White, J., Moscoso, M.S., Jacobsen, P. B., Klein, T. W., . . . Kip, K.E. (2009). Randomized controlled trial of mindfulness-based stress reduction (MBSR) for survivors of breast cancer. Psycho-Oncology, 18, 1261–1272.

To determine if a mindfulness-based stress reduction (MBSR) intervention is effective in improving psychological and physical status in breast cancer survivors

The intervention was six group sessions of an MBSR program using meditation and body scan techniques. Participants received a training manual and audiotapes to support home practice of various forms of meditation and gentle yoga. The training manual included weekly objectives, exercises, program content, and a daily diary for recording practice activities.

• The study reported on a sample of 82 female patients with breast cancer.
• In terms of age, 40% were younger than 55 years, and 27.4% were older than 65 years; the MBSR group had a significantly larger percentage of younger patients.
• All patients had undergone surgery and received either adjuvant radiation or chemotherapy. Therapy was completed within the prior 18 months.
• Of the sample, 56% were employed; 72.6% were white, non-Hispanic; 78.5% had at least some college level education; and 25% were on medications for depression.

• Single site
• Outpatient setting
• Florida

• Patients were undergoing the transition phase of care after initial treatment.
• The study has clinical applicability for late effects and survivorship.

A randomized controlled trial design was used.

• Concerns About Recurrence Scale – 30 items
• State-Trait Anxiety Inventory – 20 items
• Center for Epidemiologic Studies Depression Scale (CESDS) – 20 items
• Perceived Stress Scale – 10 items assessing how often in the past month life situations were stressful
• Life Orientation Test – 6 items to assess expectancy for positive and negative life outcomes
• Medical Outcomes Study Short Form General Health Survey
• Medical Outcomes Social Support Survey – 19 items

Seventy percent of participants were determined to be compliant with the program. Intervention participants had better mean scores for state anxiety and depression compared to the control group at six weeks (p = 0.004; p = 0.03).

The MBSR program improved psychological distress, fear of recurrence, and quality of life among patients with breast cancer who recently transitioned from active treatment. The extent of practice of MBSR activities appears to influence the overall degree of benefit derived. A large percentage of patients were able to comply with a complex MBSR intervention.

• The study had a limited follow-up period.
• The study design lacked an attentional control.

Whether benefits seen were due to the actual intervention or the supportive aspects of the group was unable to be determined. More than half of eligible patients approached for enrollment declined due to scheduling issues, travel distance, lack of interest, and other issues. This suggests that such a program is limited in application related to these types of issues.