Effects of Mindfulness Therapy on Breast Cancer Patients with Depression or Anxiety: A Systematic Review and Meta-analysis

Abstract

Background: Breast cancer (BC) is the most common malignant tumor threatening women’s health globally, with rising incidence rates and significant psychological impacts, particularly in China, where the prevalence of depressive and anxious mood disorders among BC patients is notably higher than the global average. To evaluate the effect of mindfulness therapy on anxiety and depressive symptoms in breast cancer patients, as psychological distress significantly affects their quality of life and often persists despite medical treatment. Methods: A computerized search of Web of Science, PubMed, ScienceDirect, Cochrane Library, and Embase databases was conducted for randomized controlled trials involving the effects of positive thinking interventions on anxiety and depressive symptoms in breast cancer patients. The search was conducted from the time of database construction to December 2023. Two researchers completed literature screening, data extraction, and quality assessment, and then analyzed using RevMan 5.4 software. Results: A total of 15 studies involving 1823 patients were included. Meta-analysis results demonstrated that anxiety scores [mean difference (MD) = –0.67, 95% CI (–1.05, –0.29), p = 0.0005] and depression scores [MD = –2.26, 95% CI (–2.91, –1.61), p < 0.00001] were lower in the positive mindfulness intervention group than in the control group after the intervention, and the difference was statistically significant. Meanwhile, the follow-up time (>8 weeks vs ≤8 weeks) had little effect on the improvement of patients’ depression and anxiety scores. The distribution of studies was unsymmetrical, and there was a certain degree of publication bias. Conclusion: This study provides scientific evidence and practical guidance for psychological care in breast cancer patients, supporting the effectiveness of mindfulness-based interventions (excluding mindfulness-based cognitive therapy (MBCT)) in alleviating anxiety and depression. Future research should focus on high-quality randomized controlled trials to confirm and expand these findings and explore more effective intervention strategies.