title: Long-term psychological benefits of cognitive-behavioral stress management for women with breast cancer: 11-year follow-up of a randomized controlled trial.
abstract: BACKGROUND
  Breast cancer survivors experience long-term physical and psychological sequelae after their primary treatment that negatively influence their quality of life (QOL) and increase depressive symptoms. Group-based cognitive-behavioral stress management (CBSM) delivered after surgery for early-stage breast cancer was previously associated with better QOL over a 12-month follow-up and with fewer depressive symptoms up to 5 years after study enrollment. This 8- to 15-year follow-up (median, 11 years) of a previously conducted trial (NCT01422551) evaluated whether women in this cohort receiving CBSM had fewer depressive symptoms and better QOL than controls at an 8- to 15-year follow-up.
  
  
  METHODS
  Women with stage 0 to IIIb breast cancer were initially recruited 2 to 10 weeks after surgery and randomized to a 10-week CBSM intervention or a 1-day psychoeducational control group. One hundred women (51 CBSM patients and 49 controls) were recontacted 8 to 15 years after study enrollment to participate in a follow-up assessment. The Center for Epidemiologic Studies-Depression (CES-D) scale and the Functional Assessment of Cancer Therapy-Breast (FACT-B) were self-administered. Multiple regression was employed to evaluate group differences on the CES-D scale and FACT-B over and above effects of confounding variables.
  
  
  RESULTS
  Participants assigned to CBSM reported significantly lower depressive symptoms (d, 0.63; 95% confidence interval [CI], 0.56-0.70) and better QOL (d, 0.58; 95% CI, 0.52-0.65) above the effects of the covariates.
  
  
  CONCLUSIONS
  Women who received CBSM after surgery for early-stage breast cancer reported lower depressive symptoms and better QOL than the control group up to 15 years later. Early implementation of cognitive-behavioral interventions may influence long-term psychosocial functioning in breast cancer survivors.
authors: Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts.
authors: Jamie M
authors: JM
authors: Stagl
authors: Department of Psychology, University of Miami, Coral Gables, Florida.
authors: Laura C
authors: LC
authors: Bouchard
authors: Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida.|Sylvester Cancer Center, University of Miami Miller School of Medicine, Miami, Florida.
authors: Suzanne C
authors: SC
authors: Lechner
authors: Sylvester Cancer Center, University of Miami Miller School of Medicine, Miami, Florida.|Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, Florida.
authors: Bonnie B
authors: BB
authors: Blomberg
authors: Department of Psychology, University of Miami, Coral Gables, Florida.
authors: Lisa M
authors: LM
authors: Gudenkauf
authors: Department of Psychology, University of Miami, Coral Gables, Florida.
authors: Devika R
authors: DR
authors: Jutagir
authors: Sylvester Cancer Center, University of Miami Miller School of Medicine, Miami, Florida.
authors: Stefan
authors: S
authors: Glück
authors: Baptist Health Breast Center, Miami, Florida.
authors: Robert P
authors: RP
authors: Derhagopian
authors: Department of Psychology, University of Miami, Coral Gables, Florida.|Sylvester Cancer Center, University of Miami Miller School of Medicine, Miami, Florida.
authors: Charles S
authors: CS
authors: Carver
authors: Department of Psychology, University of Miami, Coral Gables, Florida.|Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida.|Sylvester Cancer Center, University of Miami Miller School of Medicine, Miami, Florida.
authors: Michael H
authors: MH
authors: Antoni
mesh_terms: D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods*; D011788:Quality of Life; D016037:Single-Blind Method; D013315:Stress, Psychological / Q000209:etiology* / Q000628:therapy*; D017741:Survivors
keywords: breast neoplasms; cognitive therapy; depression; follow-up studies; psychological stress; quality of life; relaxation therapy; survivors