J Natl Cancer Inst. 2022 Sep 20:djac180. doi: 10.1093/jnci/djac180. Online ahead of print.
BACKGROUND: The Pathways to Wellness trial tested the efficacy of two interventions for younger breast cancer survivors: mindful awareness practices (MAPs) and survivorship education (SE). This planned secondary analysis examines intervention effects on stress, positive psychological outcomes, and inflammation (Clincaltrials.gov NCT03025139).
METHODS: Women diagnosed with breast cancer at or before age 50 who had completed treatment and had elevated depressive symptoms were randomly assigned to 6 weeks of MAPs, SE, or wait-list control (WLC). Assessments conducted at pre- and post-intervention and at 3- and 6-month follow-up measured general stress perceptions, cancer-related intrusive thoughts and worry, positive affect, meaning/peace in life, altruism/empathy, and markers of inflammation. Analyses compared change in outcomes over time in each intervention group relative to WLC using linear mixed models.
RESULTS: 247 women were randomized to MAPS (n = 85), SE (n = 81), or WLC (n = 81). MAPs statistically significantly decreased intrusive thoughts and worry at post-intervention and 3-month follow up relative to WLC (ps < .027), and statistically significantly increased positive affect and meaning/peace at post-intervention, with positive affect persisting at 3-month follow up (ps < .027). SE statistically significantly decreased intrusive thoughts at 3-month follow up and statistically significantly increased positive affect at 6-month follow up relative to WLC (ps < .01). Pro-inflammatory gene expression increased in WLC relative to MAPs (p = .016) but did not differ from SE. There were no intervention effects on other outcomes.
CONCLUSION: MAPs had beneficial effects on psychological and immune outcomes in younger breast cancer survivors and is a promising approach for enhancing biobehavioral health.