Randomized controlled trial of mindfulness-based stress reduction (MBSR) for survivors of breast cancer.
OBJECTIVE
Considerable morbidity persists among survivors of breast cancer (BC) including high levels of psychological stress, anxiety, depression, fear of recurrence, and physical symptoms including pain, fatigue, and sleep disturbances, and impaired quality of life. Effective interventions are needed during this difficult transitional period.


METHODS
We conducted a randomized controlled trial of 84 female BC survivors (Stages 0-III) recruited from the H. Lee Moffitt Cancer and Research Institute. All subjects were within 18 months of treatment completion with surgery and adjuvant radiation and/or chemotherapy. Subjects were randomly assigned to a 6-week Mindfulness-Based Stress Reduction (MBSR) program designed to self-regulate arousal to stressful circumstances or symptoms (n=41) or to usual care (n=43). Outcome measures compared at 6 weeks by random assignment included validated measures of psychological status (depression, anxiety, perceived stress, fear of recurrence, optimism, social support) and psychological and physical subscales of quality of life (SF-36).


RESULTS
Compared with usual care, subjects assigned to MBSR(BC) had significantly lower (two-sided p<0.05) adjusted mean levels of depression (6.3 vs 9.6), anxiety (28.3 vs 33.0), and fear of recurrence (9.3 vs 11.6) at 6 weeks, along with higher energy (53.5 vs 49.2), physical functioning (50.1 vs 47.0), and physical role functioning (49.1 vs 42.8). In stratified analyses, subjects more compliant with MBSR tended to experience greater improvements in measures of energy and physical functioning.


CONCLUSIONS
Among BC survivors within 18 months of treatment completion, a 6-week MBSR(BC) program resulted in significant improvements in psychological status and quality of life compared with usual care.
Lengacher
Cecile A
CA
University of South Florida College of Nursing, Tampa, FL 33612-447, USA.
Johnson-Mallard
Versie
V
Post-White
Janice
J
Moscoso
Manolete S
MS
Jacobsen
Paul B
PB
Klein
Thomas W
TW
Widen
Raymond H
RH
Fitzgerald
Shirley G
SG
Shelton
Melissa M
MM
Barta
Michelle
M
Goodman
Matthew
M
Cox
Charles E
CE
Kip
Kevin E
KE
D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology / Q000628:therapy*; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D003131:Combined Modality Therapy; D003863:Depression / Q000523:psychology / Q000628:therapy*; D005239:Fear; D005260:Female; D006801:Humans; D008016:Life Change Events; D019122:Meditation; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000523:psychology; D009367:Neoplasm Staging; D010555:Personality Inventory; D011788:Quality of Life / Q000523:psychology*; D012803:Sick Role; D012944:Social Support; D017741:Survivors / Q000523:psychology*