Impact of mindfulness practices on the quality of life of women with breast cancer: systematic review

Resumo

Objective: To determine the impact of mindfulness practices on quality of life, depression, anxiety, sleep, stress, and pain
in women with breast cancer. Methods: A systematic review was conducted following the Preferred Reporting Items for
Systematic reviews and Meta-Analyses (PRISMA) guidelines and based on randomized clinical trials that included women
with breast cancer who underwent mindfulness practices. The study was registered in the International Prospective
Register of Systematic Reviews (PROSPERO; under CRD42024502665) and included a risk of bias analysis using the RoB2
tool, statistical analysis of standardized mean differences (SMD) of questionnaire scores used to assess outcomes, metaanalysis with R software, and evidence certainty through the GRADE scale. Results: A total of 29 randomized studies
from around the world were included, comprising 3,407 women with breast cancer; 1,680 of them received the intervention
(mindfulness practice). The risk of bias was not significant in the studies. In the meta-analysis, for quality of life, mindfulness improved the SMD by 0.84 (95% confidence interval [CI] 0.19 to 1.49) with low evidence certainty. For depression,
the SMD decreased by 0.71 (95%CI -1.19 to -0.22) with moderate certainty. In anxiety, the SMD decreased by 0.48 (95%CI
-0.73 to -0.24) with moderate certainty. Sleep improved with an SMD of 0.76 (95%CI -1.37 to -0.14) with moderate certainty.
Stress decreased by SMD of 0.73 (95%CI -1.53 to -0.07), but with very low certainty, and pain decreased by SMD of 0.21
(95%CI -0.61 to 0.19), with low evidence certainty. All meta-analyses showed considerable heterogeneity of the studies.
Conclusion: Mindfulness practices may slightly improve quality of life and reduce depression and anxiety in women with
breast cancer. For sleep, stress, and pain, the evidence is uncertain. Despite the mild impact demonstrated in this study,
the broad socioeconomic accessibility of mindfulness practices may support clinical recommendation.