Background: Breast cancer patients undergoing chemotherapy frequently experience significant psychological distress, including stress, anxiety, depression, and impaired quality of life (QoL). Mindfulness-based interventions (MBIs), such as Mindfulness-Based Stress Reduction (MBSR), have been increasingly used as supportive psychosocial strategies; however, evidence regarding their effectiveness during active chemotherapy remains inconsistent.
Objective: This systematic review and meta-analysis aimed to evaluate the effectiveness of mindfulness-based interventions on stress, anxiety, depression, and quality of life among breast cancer patients receiving chemotherapy.
Methods: A systematic search of electronic databases was conducted to identify randomized controlled trials (RCTs) evaluating MBIs in breast cancer patients undergoing chemotherapy. Only RCTs published in English were included. Outcomes of interest included stress, anxiety, depression, and QoL. Meta-analyses were performed using standardized mean differences (SMDs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic.
Results: Nine RCTs involving 1,155 female breast cancer patients were included. Meta-analysis demonstrated that mindfulness-based interventions significantly reduced anxiety (SMD = −0.59; 95% CI: −0.80 to −0.39) and depression (SMD = −0.52; 95% CI: −0.73 to −0.30), with low heterogeneity. In contrast, pooled effects for stress and quality of life were not statistically significant, and substantial heterogeneity was observed across studies. Variability in intervention duration, delivery mode, outcome measures, and timing relative to chemotherapy likely contributed to inconsistent findings.
Conclusion: Mindfulness-based interventions are effective adjunctive approaches for reducing anxiety and depression in breast cancer patients undergoing chemotherapy. However, their effects on stress and overall quality of life remain variable. Further well-designed trials with standardized protocols and longer follow-up are needed to clarify these outcomes.