Effect of psychological intervention on survival outcome in breast cancer patients: a systematic review of randomized controlled trials_West China Medical Journal

Authors：

ZHU Miao ¹ , LIU Xiujuan ¹ , WANG Fei ¹ , LIU Qiongni ¹ , YANG Li ¹ , YU Min ¹ , XU Jie ¹ ,  ZHOU Tian ²

1. The Second Clinical Medical School of Beijing University of Traditional Chinese Medicine, Beijing 100078, P. R. China;
2. Oncology Department, Dong Fang Hospital of Beijing University of Traditional Chinese Medicine, Beijing 100078, P. R. China;

Corresponding?author：

ZHOU Tian, Email: zhoutian_med@163.com

Keywords：

Breast cancer; survival outcome; randomized controlled trial; psychological intervention; meta-analysis; systematic review

DOI：

10.7507/1002-0179.202410171

Video：

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Objective To systematically evaluate the effect of psychological intervention on the survival outcome of breast cancer patients. Methods PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang, Chongqing VIP were searched by computer. The search time ranged from the establishment of the databases to December 31, 2024. Randomized controlled trials of psychological intervention related to breast cancer were searched, and the studies that met the criteria were qualitatively described and meta-analyzed. Results A total of 11 randomized controlled trials were included. Meta-analysis included five studies, and the results showed that the survival rate of breast cancer patients receiving psychological intervention had no significant difference compared with breast cancer patients receiving only conventional treatment (P＞0.05). Meta-analysis of 3 studies involving early and middle stage breast cancer patients showed that there was no significant difference in survival rate between breast cancer patients receiving psychological intervention and breast cancer patients receiving only conventional treatment (P＞0.05). The qualitative analysis of the impact of psychological intervention on the survival of breast cancer patients showed that 3 studies found that psychological intervention could improve the survival of breast cancer patients, and the main outcome was to prolong the median survival or average survival. Conclusions Qualitative analysis shows that psychological intervention may improve the survival period of breast cancer patients. Due to the limited number of included studies and small sample size, the meta-analysis results failed to provide sufficient evidence that psychological intervention can improve the survival outcome of breast cancer, and this result needs further verification.

Citation： ZHU Miao, LIU Xiujuan, WANG Fei, LIU Qiongni, YANG Li, YU Min, XU Jie, ZHOU Tian. Effect of psychological intervention on survival outcome in breast cancer patients: a systematic review of randomized controlled trials. West China Medical Journal, 2025, 40(11): 1826-1831. doi: 10.7507/1002-0179.202410171 Copy

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3.	Valderrama Rios MC, Sánchez Pedraza R. Anxiety and depression disorders in relation to the quality of life of breast cancer patients with locally advanced or disseminated stage. Rev Colomb Psiquiatr (Engl Ed), 2018, 47(4): 211-220.
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7.	Jassim GA, Whitford DL, Hickey A, et al. Psychological interventions for women with non-metastatic breast cancer. Cochrane Database Syst Rev, 2015(5): CD008729.
8.	Jassim GA, Doherty S, Whitford DL, et al. Psychological interventions for women with non-metastatic breast cancer. Cochrane Database Syst Rev, 2023, 1(1): CD008729.
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13.	Boesen EH, Karlsen R, Christensen J, et al. Psychosocial group intervention for patients with primary breast cancer: a randomised trial. Eur J Cancer, 2011, 47(9): 1363-1372.
14.	Andersen BL, Yang HC, Farrar WB, et al. Psychologic intervention improves survival for breast cancer patients: a randomized clinical trial. Cancer, 2008, 113(12): 3450-3458.
15.	Kissane DW, Grabsch B, Clarke DM, et al. Supportive-expressive group therapy for women with metastatic breast cancer: survival and psychosocial outcome from a randomized controlled trial. Psychooncology, 2007, 16(4): 277-286.
16.	Spiegel D, Butler LD, Giese-Davis J, et al. Effects of supportive-expressive group therapy on survival of patients with metastatic breast cancer: a randomized prospective trial. Cancer, 2007, 110(5): 1130-1138.
17.	Kissane DW, Love A, Hatton A, et al. Effect of cognitive-existential group therapy on survival in early-stage breast cancer. J Clin Oncol, 2004, 22(21): 4255-4260.
18.	Goodwin PJ, Leszcz M, Ennis M, et al. The effect of group psychosocial support on survival in metastatic breast cancer. N Engl J Med, 2001, 345(24): 1719-1726.
19.	Ye ZJ, Qiu HZ, Liang MZ, et al. Effect of a mentor-based, supportive-expressive program, be resilient to breast cancer, on survival in metastatic breast cancer: a randomised, controlled intervention trial. Br J Cancer, 2017, 117(10): 1486-1494.
20.	Stagl JM, Lechner SC, Carver CS, et al. A randomized controlled trial of cognitive-behavioral stress management in breast cancer: survival and recurrence at 11-year follow-up. Breast Cancer Res Treat, 2015, 154(2): 319-328.
21.	張葉寧, 龐英, 何毅, 等. 進展期乳腺癌患者心理痛苦及心理治療的研究現狀及思考. 中國癌癥防治雜志, 2024, 16(5): 622-628.
22.	Cardoso F, Paluch-Shimon S, Senkus E, et al. 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5). Ann Oncol, 2020, 31(12): 1623-1649.
23.	Osman H, Shrestha S, Temin S, et al. Palliative care in the global setting: ASCO resource-stratified practice guideline. J Glob Oncol, 2018, 4: 1-24.
24.	國家腫瘤質控中心乳腺癌專家委員會, 中國抗癌協會乳腺癌專業委員會, 中國抗癌協會腫瘤藥物臨床研究專業委員會. 中國晚期乳腺癌規范診療指南(2020 版). 中華腫瘤雜志, 2020, 42(10): 781-797.

1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
2. 鄭榮壽, 陳茹, 韓冰峰, 等. 2022 年中國惡性腫瘤流行情況分析. 中華腫瘤雜志, 2024, 46(3): 221-231.
3. Valderrama Rios MC, Sánchez Pedraza R. Anxiety and depression disorders in relation to the quality of life of breast cancer patients with locally advanced or disseminated stage. Rev Colomb Psiquiatr (Engl Ed), 2018, 47(4): 211-220.
4. Eckerling A, Ricon-Becker I, Sorski L, et al. Stress and cancer: mechanisms, significance and future directions. Nat Rev Cancer, 2021, 21(12): 767-785.
5. Spiegel D, Bloom JR, Kraemer HC, et al. Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet, 1989, 2(8668): 888-891.
6. Mustafa M, Carson-Stevens A, Gillespie D, et al. Psychological interventions for women with metastatic breast cancer. Cochrane Database Syst Rev, 2013, 2013(6): CD004253.
7. Jassim GA, Whitford DL, Hickey A, et al. Psychological interventions for women with non-metastatic breast cancer. Cochrane Database Syst Rev, 2015(5): CD008729.
8. Jassim GA, Doherty S, Whitford DL, et al. Psychological interventions for women with non-metastatic breast cancer. Cochrane Database Syst Rev, 2023, 1(1): CD008729.
9. Higgins JP, Altman DG, G?tzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ, 2011, 343: d5928.
10. Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454): 1490.
11. Cunningham AJ, Edmonds CV, Jenkins GP, et al. A randomized controlled trial of the effects of group psychological therapy on survival in women with metastatic breast cancer. Psychooncology, 1998, 7(6): 508-517.
12. Edelman S, Lemon J, Bell DR, et al. Effects of group CBT on the survival time of patients with metastatic breast cancer. Psychooncology, 1999, 8(6): 474-481.
13. Boesen EH, Karlsen R, Christensen J, et al. Psychosocial group intervention for patients with primary breast cancer: a randomised trial. Eur J Cancer, 2011, 47(9): 1363-1372.
14. Andersen BL, Yang HC, Farrar WB, et al. Psychologic intervention improves survival for breast cancer patients: a randomized clinical trial. Cancer, 2008, 113(12): 3450-3458.
15. Kissane DW, Grabsch B, Clarke DM, et al. Supportive-expressive group therapy for women with metastatic breast cancer: survival and psychosocial outcome from a randomized controlled trial. Psychooncology, 2007, 16(4): 277-286.
16. Spiegel D, Butler LD, Giese-Davis J, et al. Effects of supportive-expressive group therapy on survival of patients with metastatic breast cancer: a randomized prospective trial. Cancer, 2007, 110(5): 1130-1138.
17. Kissane DW, Love A, Hatton A, et al. Effect of cognitive-existential group therapy on survival in early-stage breast cancer. J Clin Oncol, 2004, 22(21): 4255-4260.
18. Goodwin PJ, Leszcz M, Ennis M, et al. The effect of group psychosocial support on survival in metastatic breast cancer. N Engl J Med, 2001, 345(24): 1719-1726.
19. Ye ZJ, Qiu HZ, Liang MZ, et al. Effect of a mentor-based, supportive-expressive program, be resilient to breast cancer, on survival in metastatic breast cancer: a randomised, controlled intervention trial. Br J Cancer, 2017, 117(10): 1486-1494.
20. Stagl JM, Lechner SC, Carver CS, et al. A randomized controlled trial of cognitive-behavioral stress management in breast cancer: survival and recurrence at 11-year follow-up. Breast Cancer Res Treat, 2015, 154(2): 319-328.
21. 張葉寧, 龐英, 何毅, 等. 進展期乳腺癌患者心理痛苦及心理治療的研究現狀及思考. 中國癌癥防治雜志, 2024, 16(5): 622-628.
22. Cardoso F, Paluch-Shimon S, Senkus E, et al. 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5). Ann Oncol, 2020, 31(12): 1623-1649.
23. Osman H, Shrestha S, Temin S, et al. Palliative care in the global setting: ASCO resource-stratified practice guideline. J Glob Oncol, 2018, 4: 1-24.
24. 國家腫瘤質控中心乳腺癌專家委員會, 中國抗癌協會乳腺癌專業委員會, 中國抗癌協會腫瘤藥物臨床研究專業委員會. 中國晚期乳腺癌規范診療指南(2020 版). 中華腫瘤雜志, 2020, 42(10): 781-797.

West China Medical Journal

Effect of psychological intervention on survival outcome in breast cancer patients: a systematic review of randomized controlled trials

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