TY - JOUR
T1 - Efficacy of Multimodal Psychological Interventions on Pain After Surgery in Breast Cancer Survivors
T2 - A Systematic Review
AU - Kennedy, Samantha K.F.
AU - Sadeghi, Sarina
AU - Dehkordi, Shayan Raeisi
AU - Lee, Shing Fung
AU - Kirk, Deborah
AU - Cheung, Yin Ting
AU - Haywood, Darren
AU - Grech, Lisa
AU - Ramsey, Imogen
AU - Guedes, Helena
AU - Zhou, Jerry
AU - Fazelzad, Rouhi
AU - Narusawa, Eriko
AU - Tane, Kaori
AU - Hart, Nicolas H.
AU - Peera, Malika
AU - Patel, Ayush
AU - Fuller-Shavel, Nina
AU - Sheng, Ying
AU - Ashbury, Fredrick D.
AU - Wong, Henry C.Y.
AU - Kwan, Jennifer Yin Yee
AU - Chow, Edward
AU - Jefford, Michael
AU - Chan, Raymond J.
AU - Kikawa, Yuichiro
AU - Al-Khaifi, Muna
AU - the Multinational Association of Supportive Care in Cancer (MASCC) Survivorship Study Group
PY - 2025/6/26
Y1 - 2025/6/26
N2 - 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 5 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 5 1), relaxation modification (n 5 1), progressive muscular relaxation combined with visualization (n 5 1), Qigong mind-body exercise (n 5 1), pranic meditation (n 5 1), supportive-expressive group therapy (n 5 1), diaphragmatic breathing with progressive muscle relaxation (n 5 1), and integrated yoga programs (n 5 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.
AB - 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 5 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 5 1), relaxation modification (n 5 1), progressive muscular relaxation combined with visualization (n 5 1), Qigong mind-body exercise (n 5 1), pranic meditation (n 5 1), supportive-expressive group therapy (n 5 1), diaphragmatic breathing with progressive muscle relaxation (n 5 1), and integrated yoga programs (n 5 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.
KW - breast cancer surgery
KW - Breast cancer survivorship care (BCSC)
KW - postsurgical pain
KW - multimodal psychological interventions
KW - systematic review
UR - http://www.scopus.com/inward/record.url?scp=105010356884&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/2017080
UR - http://purl.org/au-research/grants/NHMRC/1194051
U2 - 10.1200/OP-25-00081
DO - 10.1200/OP-25-00081
M3 - Review article
C2 - 40570265
AN - SCOPUS:105010356884
SN - 2688-1527
JO - JCO Oncology Practice
JF - JCO Oncology Practice
ER -
