Efficacy of multimodal psychological interventions on pain after surgery in breast cancer survivors: A systematic review
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 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.
RAS ID
83409
Document Type
Journal Article
Date of Publication
1-1-2025
Funding Information
National Health and Medical Research Council / Hold'em for Life Early Career Professorship
PubMed ID
40570265
School
School of Nursing and Midwifery / Exercise Medicine Research Institute / School of Medical and Health Sciences
Grant Number
NHMRC Number : APP2017080, APP1194051
Copyright
subscription content
Publisher
Lippincott Williams and Wilkins
Identifier
Deborah Kirk: https://orcid.org/0000-0003-2992-3389
Nicolas H. Hart: https://orcid.org/0000-0003-2794-0193
Recommended Citation
Kennedy, S. K., Sadeghi, S., Dehkordi, S., Lee, S., Kirk, D., Cheung, Y., Haywood, D., Grech, L., Ramsey, I., Guedes, H., Zhou, J., Fazelzad, R., Narusawa, E., Tane, K., Hart, N. H., Peera, M., Patel, A., Fuller-Shavel, N., Sheng, Y., Ashbury, F. D., Wong, H. C., Kwan, J., Chow, E., Jefford, M., Chan, R. J., & Kikawa, Y. (2025). Efficacy of multimodal psychological interventions on pain after surgery in breast cancer survivors: A systematic review. Retrieved from https://ro.ecu.edu.au/ecuworks2022-2026/6713
Comments
Kennedy, S. K., Sadeghi, S., Dehkordi, S. R., Lee, S. F., Kirk, D., Cheung, Y. T., Haywood, D., Grech, L., Ramsey, I., Guedes, H., Zhou, J., Fazelzad, R., Narusawa, E., Tane, K., Hart, N. H., Peera, M., Patel, A., Fuller-Shavel, N., Sheng, Y., . . . Al-Khaifi, M. (2025). Efficacy of multimodal psychological Interventions on pain after surgery in breast cancer survivors: A systematic review. JCO Oncology Practice. Advance online publication. https://doi.org/10.1200/OP-25-00081