Huang, H.P., He, M., Wang, H.Y., & Zhou, M. (2016). A meta-analysis of the benefits of mindfulness-based stress reduction (MBSR) on psychological function among breast cancer (BC) survivors. Breast Cancer (Tokyo, Japan), 23, 568–576.

STUDY PURPOSE: Evaluate benefits of MBSR on psychological distress

TYPE OF STUDY: Meta analysis and systematic review

DATABASES USED: PubMed, EMBASE, and Cochrane Central Register from inception to June 2014

INCLUSION CRITERIA: RCT; comparison of MBSR to usual care; breast cancer; measures psychological outcomes such as anxiety, depression, or stress

EXCLUSION CRITERIA: Other types of cancer; did not use MBSR; unpublished

TOTAL REFERENCES RETRIEVED: 323

EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Risk of bias assessment according to the Cochrane handbook. Five studies included were not RCTs, despite this as an inclusion criteria. Only one study showed appropriate randomization and was blinded. Non-RCTs were all high risk of bias.

FINAL NUMBER STUDIES INCLUDED: 8

TOTAL PATIENTS INCLUDED IN REVIEW: 964

SAMPLE RANGE ACROSS STUDIES: 13-336

KEY SAMPLE CHARACTERISTICS: All were women with breast cancer

PHASE OF CARE: Not specified or not applicable

Six studies (536 patients) recorded a significant effect on depression (MD = 5.09, p < 0.00001). Four of these studies were pre-/post-test design studies.  Four studies showed a significant effect on anxiety with MBSR (MD 2.79, p < 0.0001). Four studies investigated long-range results from 1 to 24 months. Two showed sustained effects of MBSR at 12 and 24 months.

MBSR is effective for reducing anxiety and depression among women with breast cancer.

• Limited search
• Limited number of studies included
• Mostly low quality/high risk of bias studies
• Low sample sizes
• It is not clear if all studies used traditional MBSR or the more recently seen shortened version of the intervention. Despite an inclusion criteria of RCT, the majority of studies included were not RCTs.

MBSR can be helpful for patients to reduce anxiety and depression. There is some debate about the best form of delivery and full content of MBSR interventions. Additional research is needed to determine if delivery of the intervention for self care via CD or DVD or via Internet applications is effective. Additional research is also needed to determine if shortened interventions that do not include a retreat are as effective, since the time commitment and cost of a retreat may be prohibitive in some cases.