Managing psychological distress in women with breast cancer: A systematic review of intervention trends in the past decade.

OBJECTIVE

The rising incidence and survival rates of breast cancer have increased the number of breast cancer survivors (BCSs) experiencing psychological distress that often overlaps with anxiety, depression, and fear of recurrence. Many existing interventions neglect the unique psychosocial contexts of BCSs, and unclear definitions of distress hinder consistent assessment and management. This systematic review evaluated recent interventions targeting psychological distress in BCSs and offers evidence-based insights.

METHODS

Following PRISMA guidelines, six databases were searched for randomized controlled trials on distress interventions for BCSs published between 2014 and July 2025. Study quality was evaluated using Cochrane's RoB 2 tool, and data on intervention characteristics, outcomes, and measurement instruments were extracted.

RESULTS

Fourteen randomized control trials involving 2447 BCSs were included. Among them, 8 (57%) report significant reductions, with six showing immediate post-intervention effects and two demonstrating effects only at follow-up (effect sizes ranged from small to large, Cohen's d = 0.44-1.54). Effective interventions included mindfulness-based approaches, virtual reality-integrated psychotherapy, and cognitive-behavioral therapy combined with hypnosis. In contrast, cognitive-focused interventions lacking experiential components and minimally structured digital programs showed non-significant results.

CONCLUSIONS

Effective distress management requires multimodal, theory-based interventions delivered by trained professionals, rather than cognitive-focused or minimally structured approaches. Future interventions should incorporate standardized distress assessment tools and clearly articulated theoretical frameworks, focusing on younger survivors, who remain significantly underrepresented. Although digital platforms enhance accessibility, their effectiveness depends on evidence-based content and structured implementation. Strengthening these elements will improve both the comparability and overall effectiveness of interventions for BCSs.