Cited by 398Mindfulness and Compassion InterventionsCancer survivorship and careWomen's cancer prevention and management

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Effectiveness of Mindfulness-Based Stress Reduction in Mood, Breast- and Endocrine-Related Quality of Life, and Well-Being in Stage 0 to III Breast Cancer: A Randomized, Controlled Trial

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Hoffman, Caroline J., Ersser, Steven J., Hopkinson, Jane B., Nicholls, Peter G., Harrington, Julia E., Thomas, Peter W.·2012·Journal of Clinical Oncology

DOI 10.1200/jco.2010.34.0331

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Abstract

Purpose: To assess the effectiveness of mindfulness-based stress reduction (MBSR) for mood, breast- and endocrine-specific quality of life, and well-being after hospital treatment in women with stage 0 to III breast cancer. Patients and Methods: A randomized, wait-listed, controlled trial was carried out in 229 women after surgery, chemotherapy, and radiotherapy for breast cancer. Patients were randomly assigned to the 8-week MBSR program or standard care. Profile of Mood States (POMS; primary outcome), Functional Assessment of Cancer Therapy–Breast (FACT-B), Functional Assessment of Cancer Therapy–Endocrine Symptoms (FACT-ES) scales and the WHO five-item well-being questionnaire (WHO-5) evaluated mood, quality of life, and well-being at weeks 0, 8, and 12. For each outcome measure, a repeated-measures analysis of variance model, which incorporated week 0 measurements as a covariate, was used to compare treatment groups at 8 and 12 weeks. Results: There were statistically significant improvements in outcome in the experimental group compared with control group at both 8 and 12 weeks (except as indicated) for POMS total mood disturbance (and its subscales of anxiety, depression [8 weeks only], anger [12 weeks only], vigor, fatigue, and confusion [8 weeks only]), FACT-B, FACT-ES, (and Functional Assessment of Cancer Therapy subscales of physical, social [8 weeks only], emotional, and functional well-being), and WHO-5. Conclusion: MSBR improved mood, breast- and endocrine-related quality of life, and well-being more effectively than standard care in women with stage 0 to III breast cancer, and these results persisted at three months. To our knowledge, this study provided novel evidence that MBSR can help alleviate long-term emotional and physical adverse effects of medical treatments, including endocrine treatments. MBSR is recommended to support survivors of breast cancer.

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BackgroundInfluential
Predictors and Effects of Class Attendance and Home Practice of Yoga and Meditation Among Breast Cancer Survivors in a Mindfulness-Based Cancer Recovery (MBCR) Program
Tamagawa, R., Speca, M., Stephen, J., Pickering, B., Lawlor-Savage, L., & Carlson, L. E. (2015) · Mindfulness · doi:10.1007/s12671-014-0381-4 · Cited by 24
“We examined a range of psychological outcomes previously affected by MBIs among cancer patients, including mood, quality of life, spiritual wellbeing, and post-traumatic growth (Garland et al. 2007; Hoffman et al. 2012; Speca et al. 2000), as part of an ongoing MBCR clinical trial (Carlson et al.”
BackgroundInfluential
Understanding benefit finding among patients with colorectal cancer: a longitudinal study
Zimmaro, L. A., Deng, M., Handorf, E. R., Fang, C. Y., Denlinger, C. S., & Reese, J. B. (2020) · Supportive Care in Cancer · doi:10.1007/s00520-020-05758-6 · Cited by 23
“Patients in the study reported relatively low levels of distress at baseline in comparison to normative data from other cancer samples [28, 39, 40], and distress did not change over time, making it possible that the limited variance masked potential associations.”
Result
A qualitative evaluation of the use of interventions to treat fatigue among cancer survivors: A healthcare provider’s view
Martin, É., Zingarello, A., Meglio, A. D., Baciarello, G., Matias, M., Charles, C., Arvis, J., Dumas, A., Menvielle, G., & Vaz-Luís, I. (2020) · European Journal of Cancer Care · doi:10.1111/ecc.13370 · Cited by 26
Systematic review and meta-analysis of the efficacy and safety of psychological intervention nursing on the quality of life of breast cancer patients
Li, H., Li, J., Wang, X., Lin, S., Yang, W., Cai, H., & Feng, X. (2022) · Gland Surgery · doi:10.21037/gs-22-206 · Cited by 23
Effects of a Mindfulness-Based Stress Reduction Program on Stress, Depression, and Psychological Well-being in Patients With Cancer
Yıldırım, D., Yıldız, C. Ç., Ozdemir, F. A., Özdoğan, M. H., & Can, G. (2022) · Cancer Nursing · doi:10.1097/ncc.0000000000001173 · Cited by 33
A critical evaluation of quality of life in clinical trials of breast cancer patients treated with radiation therapy
Marta, G. N., de Moraes, F. Y., Leite, E. T. T., Chow, E., Cella, D. F., & Bottomley, A. (2017) · Annals of Palliative Medicine · doi:10.21037/apm.2017.09.06 · Cited by 23
“8%) of the studies (33-44); toxicity was the primary endpoint for 44 (24.”
Background
A Non-randomized Controlled Trial of EMDR on Affective Symptoms in Patients With Glioblastoma Multiforme
Szpringer, M., Oledzka, M., & Amann, B. L. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.00785 · Cited by 22
“Various other forms of psychotherapeutic assistance in the case of cancer patients (Hagerty et al., 2005; Strong et al., 2007; Espie et al., 2008; Hoffman et al., 2012) have been performed but not in a pure GBM sample.”
Background
The effect of a single session of 30-min mindful breathing in reducing fatigue among patients with haematological cancer – a randomised controlled trial
Ng, D., Gan, G., Anuar, N. A., Tung, Y., Lai, N.-Z., Tan, Y., Said, S., Madihie, A., Chai, C., & Tan, S. (2021) · BMC Palliative Care · doi:10.1186/s12904-021-00855-7 · Cited by 16
Neoadjuvant Chemotherapy in Breast Cancer: An Advanced Personalized Multidisciplinary Prehabilitation Model (APMP-M) to Optimize Outcomes
Leone, A. D., Terribile, D. A., Magno, S., Sánchez, A. M., Scardina, L., Mason, E. J., D’Archi, S., Maggiore, C., Rossi, C., Micco, A. D., et al. (2021) · Journal of Personalized Medicine · doi:10.3390/jpm11050324 · Cited by 22
“In addition, improvements have been noted in sleep [72,74], quality of life, and psychosocial adjustments [70], as well as in the long-term adverse effects associated with treatment [65].”
Background
Validation of the WHO-5 Well-Being Scale among Adolescents in Ghana: Evidence-Based Assessment of the Internal and External Structure of the Measure
Quansah, F., Hagan, J. E., Ankomah, F., Agormedah, E. K., Nugba, R. M., Srem‐Sai, M., & Schack, T. (2022) · Children · doi:10.3390/children9070991 · Cited by 22
“In addition, the scale (WHO-5) has been applied in different fields/disciplines using different population groups with diverse health conditions including patients with cancer [15,16]; Type 1 and 2 diabetes [17–20]; depression [21,22]; suicidal behaviors [23,24]; cardiovascular disease (e.”
Method
Effects of Mindfulness-Based Interventions on Depression in Patients With Breast Cancer: A Systematic Review and Meta-Analysis
Reangsing, C., Punsuwun, S., & Keller, K. (2023) · Integrative Cancer Therapies · doi:10.1177/15347354231220617 · Cited by 22
Reduced Emotional Reactivity in Breast Cancer Survivors with Chronic Neuropathic Pain Following Mindfulness-Based Stress Reduction (MBSR): an fMRI Pilot Investigation.
Hatchard, T., Mioduszewski, O., Khoo, E.-L., Romanow, H., Shergill, Y., Tennant, E., Leeming, A., Fang, Z., Poulin, P., & Smith, A. M. (2021) · Mindfulness · doi:10.1007/s12671-020-01546-9 · Cited by 21
Breast Cancer: A Lifestyle Medicine Approach
Orman, A., Johnson, D. L., Comander, A. H., & Brockton, N. T. (2020) · American Journal of Lifestyle Medicine · doi:10.1177/1559827620913263 · Cited by 23
Effects of an Integrative Mind-Body-Medicine Group Program on Breast Cancer Patients During Chemotherapy: An Observational Study
Haller, H., Choi, K., Lange, S., Kümmel, S., Paul, A. E., Cramer, H., Dobos, G. J., & Voiß, P. (2020) · Current Pharmaceutical Design · doi:10.2174/1381612826666201211111122 · Cited by 22
Breast cancer survivors’ recollection of their illness and therapy seven years after enrolment into a randomised controlled clinical trial
Lindberg, P., Koller, M. T., Steinger, B., Lorenz, W., Wyatt, J. C., Inwald, E. C., & Klinkhammer‐Schalke, M. (2015) · BMC Cancer · doi:10.1186/s12885-015-1573-6 · Cited by 22
“Furthermore, numerous more recent studies investigated various therapeutic approaches (stress reduction, exercise, counselling, spiritual therapy) for improvement of quality of life in randomised controlled trials [13–16].”
Background
Well-Being and Associated Factors among Women in the Gender-Segregated Country
Jradi, H., & Abbas, O. A. (2017) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph14121573 · Cited by 21
“Examples of the study fields in which the WHO-5 item questionnaire has been applied include cardiology [14], oncology [15], psychology, geriatrics [8], diabetes [16], and occupational health [17].”
Background
Being mindful of mindfulness interventions in cancer: A systematic review of intervention reporting and study methodology
Shaw, J. M., Sekelja, N., Frasca, D., Dhillon, H. M., & Price, M. A. (2018) · Psycho-Oncology · doi:10.1002/pon.4651 · Cited by 20
“While most studies (n = 27) provided some information regarding who administered the training and/or their mindfulness experience, only 9 provided detailed information of both administrator training and experience.(21,22,26,28,29,31,32,43,46) Mean quality score for intervention administration reporting was 8.”
Background
The multicultural conceptualisation of well-being
Adedeji, A., Olonisakin, T. T., Buchcik, J., Metzner, F., Tsabedze, W. F., Boehnke, K., & Idemudia, E. S. (2023) · BMC Public Health · doi:10.1186/s12889-023-16966-0 · Cited by 20
Psychological effects of meditation at a Buddhist monastery in Myanmar
Kasai, Y., Sakakibara, T., Kyaw, T. A., Soe, Z. W., Han, Z. M., & Htwe, M. M. (2015) · Journal of Mental Health · doi:10.3109/09638237.2015.1124405 · Cited by 19
“…used as a therapeutic measure because it organizes people’s thoughts in the brain, strengthens the mind, and can effectively reduce stress, mitigate pain, and improve the mental health of cancer patients (Banks et al., 2015; Hoffman et al., 2012; Kiran et al., 2014; Orme-Johnson & Barnes, 2014).”
Background
A Prospective Pilot Clinical Trial of “The Work” Meditation Technique for Survivors of Breast Cancer
Lev-ari, S., Zilcha-Mano, S., Rivo, L., Geva, R., & Ron, I. (2013) · European Journal of Integrative Medicine · doi:10.1016/j.eujim.2013.07.003 · Cited by 19
Topically Applied Therapies for the Treatment of Skin Disease: Past, Present, and Future
Brown, M. B., Williams, A., Chilcott, R. P., Brady, B., Lenn, J. D., Evans, C., Allen, L., McAuley, W. J., Beebeejaun, M., Haslinger, J., et al. (2024) · Pharmacological Reviews · doi:10.1124/pharmrev.123.000549 · Cited by 20
Health-related quality of life among women with ductal carcinomain situor early invasive breast cancer: validation of the FACT-B (version 4)
Hahn, E. A., Segawa, E., Kaiser, K., Cella, D. F., & Smith, B. D. (2016) · Expert Review of Quality of Life in Cancer Care · doi:10.1080/23809000.2016.1134259 · Cited by 19
Pharmacological treatment of depression in women with breast cancer: a systematic review
Andersen, L. T., Hansen, M. V., Rosenberg, J., & Gögenür, I. (2013) · Breast Cancer Research and Treatment · doi:10.1007/s10549-013-2708-6 · Cited by 19
“To our knowledge, four RCTs exist on mindfulness-based stress reduction compared with usual supportive care after a diagnosis of breast cancer [46–49].”
Background
Effectiveness of the Mindfulness Art Therapy Short Version for Japanese Patients With Advanced Cancer
Ando, M., Kira, H., Hayashida, S., & Ito, S. (2016) · Art Therapy · doi:10.1080/07421656.2016.1128764 · Cited by 19
“The Mindfulness-Based Stress Reduction (MBSR) program developed by Kabat-Zinn (1990) is effective for increasing positive mood and quality of life (Hoffman et al., 2012), reducing mood disturbance and stress symptoms (Speca, Carlson, Goodey, & Angen, 2000), supporting spirituality (Garland, Carson,…”
Background
Improving Psychosocial Functioning in Mastectomized Women Through a Mindfulness-Based Program: Flow Meditation.
Franco, C., Amutio, A., Mañas, I., Sánchez-Sánchez, L. C., & Mateos-Pérez, E. (2020) · International Journal of Stress Management · doi:10.1037/str0000120 · Cited by 21
Psychological stress on cancer progression and immunosenescence
Huang, Y., Zhan, Y., & Zhan, Y. (2025) · Seminars in Cancer Biology · doi:10.1016/j.semcancer.2025.05.007 · Cited by 19
The Effect of Stress Management Model in Quality of Life in Breast Cancer Women
Khodabakhshi‐Koolaee, A., Falsafinejad, M. R., & Akbari, M. (2015) · Iranian Journal of Cancer Prevention · doi:10.17795/ijcp-3435 · Cited by 18
The role of non-ordinary states of consciousness occasioned by mind-body practices in mental health illness
Corso, S. J. F., O’Malley, K. Y., Subaiya, S., Mayall, D., & Dakwar, E. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.04.116 · Cited by 20
Mindfulness-based relapse prevention – A meta-analysis
Vadivale, A. M., & Sathiyaseelan, A. (2019) · Cogent Psychology · doi:10.1080/23311908.2019.1567090 · Cited by 17
“…in substance abuse disorders (Brewer et al.,) In others mindfulness can reduce stress and also help in reduction of diabetes (Van Son et al., 2013), hypertension (Hughes et al., 2013) and relieve pain in patients suffering with cancer (CoronadoMontoya et al., 2016; Hoffman et al., 2012).”
Background
Impact of transcranial direct current stimulation on sustained attention in breast cancer survivors: Evidence for feasibility, tolerability, and initial efficacy
Gaynor, A. M., Pergolizzi, D., Alici, Y., Ryan, E., McNeal, K., Ahles, T. A., & Root, J. C. (2020) · Brain stimulation · doi:10.1016/j.brs.2020.04.013 · Cited by 17
Terapias cognitivo-conductuales de tercera generación (TTG): la atención plena / mindfulness
Moreno-Coutiño, A. B. (2012) · Revista Internacional de Psicología · doi:10.33670/18181023.v12i01.66 · Cited by 22
Mindfulness-based psychosocial interventions and psychological wellbeing in cancer survivorship: a meta-analysis
Telles, R., Whitney, B. M., Froelich, S., & Lutgendorf, S. K. (2024) · Health Psychology Review · doi:10.1080/17437199.2024.2336014 · Cited by 19
Review complementary and integrative interventions for cancer-related cognitive changes
Myers, J. S. (2015) · Asia-Pacific Journal of Oncology Nursing · doi:10.4103/2347-5625.162825 · Cited by 16
Function of microRNA‑141 in human breast cancer through cytotoxic CD4+ T cells regulated by MAP4K4 expression
Zhang, Q. H., Xin, H., & Tang, F. (2018) · Molecular Medicine Reports · doi:10.3892/mmr.2018.8814 · Cited by 16
“At present, indexes used for clinical prognostic evaluation of breast cancer include consideration of the number of metastatic lymph nodes, expression of estrogen receptor (ER), progesterone receptor and herstatin, tumor diameter and histological grade (6).”
Acupuncture for hot flashes in hormone receptor‐positive breast cancer: A pooled analysis of individual patient data from parallel randomized trials
Lu, W., Giobbie‐Hurder, A., Tanasijevic, A. M., Kassis, S. B., Park, S. H., Jeong, Y. J., Shin, I. H., Yao, C., Jung, H. J., Zhu, Z., et al. (2024) · Cancer · doi:10.1002/cncr.35374 · Cited by 15
“24–26 The ESS contains 19 items that specifically assess endocrine symptoms, including hot flashes, night sweats, vaginal dryness, and joint pain, with scores ranging from 0 to 76.”
Effects of mindfulness-based stress reduction on cancer-related fatigue in patients with breast cancer: a meta-analysis of randomized controlled trials
Lan, X., Xie, H., Fu, L., & Peng, W. (2024) · Frontiers in Oncology · doi:10.3389/fonc.2024.1425563 · Cited by 16
Real-World Evidence from the Integrative Medicine Primary Care Trial (IMPACT): Assessing Patient-Reported Outcomes at Baseline and 12-Month Follow-Up
Crocker, R. L., Hurwitz, J., Grizzle, A., Abraham, I., Rehfeld, R., Horwitz, R., Weil, A., & Maizes, V. (2019) · Evidence-Based Complementary and Alternative Medicine · doi:10.1155/2019/8595409 · Cited by 14
Relationship of perceived everyday cognitive function and work engagement in breast cancer survivors
Ah, D. M. V., & Crouch, A. (2021) · Supportive Care in Cancer · doi:10.1007/s00520-020-05950-8 · Cited by 15
Influence of preoperative life satisfaction on recovery and outcomes after colorectal cancer surgery - a prospective pilot study
Romain, B., Rohmer, O., Schimchowitsch, S., Hübner, M., Delhorme, J., Brigand, C., Rohr, S., & Guénot, D. (2018) · Health and Quality of Life Outcomes · doi:10.1186/s12955-017-0824-4 · Cited by 15
“Such research notes the importance of patients being provided with early psychological support and being helped to develop self-management skills to better cope with illness and surgical outcomes [35].”
Background
Exploring perceptions of mental health clients and professionals about Buddhism‐based therapies at mental health hospitals in Vietnam
Nguyen, H. (2018) · Asian Social Work and Policy Review · doi:10.1111/aswp.12142 · Cited by 14

Authors: Hoffman, C. J., Ersser, S. J., Hopkinson, J. B., Nicholls, P. G., Harrington, J. E., & Thomas, P. W.
Affiliations: University of Hull (GB)
University of Nottingham (GB)
ORCID: Hoffman, Caroline J.
Ersser, Steven J.
Hopkinson, Jane B.
Harrington, Julia E.
Thomas, Peter W.
Venue: Journal of Clinical Oncology
Publisher: American Society of Clinical Oncology (ASCO)
Published: 2012-04-20
Volume: 30
Issue: 12
Pages: 1335-1342
ISSN: 0732-183X (ISSN-L)
1527-7755
DOI: 10.1200/jco.2010.34.0331
OpenAlex: W2124295124
Cited by: 398
References: 37
Citations by year: 2026: 16 · 2025: 17 · 2024: 24 · 2023: 34 · 2022: 37 · 2021: 33 · 2020: 25 · 2019: 27 · 2018: 28 · 2017: 23 · 2016: 31 · 2015: 30 · 2014: 35 · 2013: 19 · 2012: 14
FWCI: 35.56
Type: journal article
Language: en
Open access: green
hull-repository.worktribe.com
Licence: other-oa
Locations: Journal of Clinical Oncology (publishedVersion)
PubMed (publishedVersion)
Repository@Hull (Worktribe) (University of Hull) (acceptedVersion, other-oa)
Repository@Hull (Worktribe) (University of Hull) (submittedVersion, cc-by)
ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Health Sciences › Medicine › Oncology › Cancer survivorship and care
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
Keywords: mindfulness-based stress reduction, breast cancer, mood, quality of life, well-being, endocrine therapy side effects, breast cancer survivors, anxiety, depression, fatigue, FACT-B, FACT-ES, WHO-5
MeSH terms: Adaptation, Psychological, Adult, Affect, Aged, Aged, 80 and over, Anxiety Disorders, Breast Neoplasms, Depression, Female, Humans, Mastectomy, Middle Aged, Neoplasm Staging, Preoperative Care, Quality of Life, Reference Values, Stress, Psychological, Waiting Lists, Treatment Outcome, Patient Satisfaction, Risk Assessment, Meditation

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Effectiveness of Mindfulness-Based Stress Reduction in Mood, Breast- and Endocrine-Related Quality of Life, and Well-Being in Stage 0 to III Breast Cancer: A Randomized, Controlled Trial

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