Efficacy of Multimodal Psychological Interventions on Pain After Surgery in Breast Cancer Survivors: A Systematic Review
Journal Title
JCO Oncology Practice
Publication Type
Online publication before print
Abstract
INTRODUCTION: Postsurgical pain is common among people who undergo breast cancer (BC) surgery and affects health-related quality of life. The aim of this systematic review was to determine the efficacy of multimodal psychologic interventions to reduce pain after BC surgery. METHODS: Nine bibliographic databases and three trial registries were searched from their inception to September 2024. Studies were included if they reported pain outcomes of multimodal psychologic interventions performed after BC surgery. This systematic review was prospectively registered on PROSPERO (CRD42024506835) and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses and synthesis without meta-analysis guidelines. RESULTS: A total of 2,876 studies were screened, with 18 meeting inclusion criteria including 10 randomized control trials (55.6%). There was a total of 1,712 patients (median sample size was 77). The greatest proportion of studies were conducted in the United States (n = 7, 38.9%). Mindfulness-based stress reduction (MBSR) was the most investigated intervention (4/18, 22.2%), followed by yoga (3/18, 16.7%). The most used pain questionnaires were the Brief Pain Inventory and European Organisation of Research and Treatment of Cancer Quality of Life Questionnaire C30 (5/18, 27.8%). Mindfulness-based cognitive therapy (n = 1), relaxation modification (n = 1), progressive muscular relaxation combined with visualization (n = 1), Qigong mind-body exercise (n = 1), pranic meditation (n = 1), supportive-expressive group therapy (n = 1), diaphragmatic breathing with progressive muscle relaxation (n = 1), and integrated yoga programs (n = 3) demonstrated a significant reduction in pain. CONCLUSION: These findings indicate the potential for multimodal psychologic interventions to reduce pain after BC surgery. However, MBSR was not significantly effective in pain reduction for BC survivors despite being the most frequently investigated intervention. Further randomized controlled trials are necessary to offer conclusive recommendations.
Department(s)
Health Services Research
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Creation Date: 2025-07-31 02:10:14
Last Modified: 2025-07-31 02:10:50
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