Efficacy of Psychological Interventions on Psychological and Vasomotor Symptoms in Menopausal Women with Breast Cancer: A Systematic Review and Meta-Analysis

Abstract

Context: The intersection of menopause and breast cancer often impairs patients' quality of life due to the accompanying physical and psychological burdens. This study examined the efficacy of mindfulness and cognitive-behavioral therapy (CBT) on menopausal breast cancer patients' physical and psychological symptoms. Objectives: To evaluate the efficacy of mindfulness and CBT interventions in reducing physical and psychological symptoms in menopausal women with breast cancer. Data Sources: This PROSPERO-registered meta-analysis (CRD42021275803) was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Clinical trials published up to January 31, 2025, were identified through systematic searches of PubMed, Web of Science, Scopus, and the Cochrane Library. Study Selection: Eight studies, with sample sizes ranging from 21 to 255, were assessed using the quality assessment checklist and the Cochrane risk of bias tool. Results: A random-effects meta-analysis of eight studies (sample sizes ranging from 21 to 225 participants) demonstrated significant improvements in vasomotor symptoms — specifically hot flashes and night sweats — following mindfulness-based and CBT interventions [standardized mean difference (SMD) = 0.961; 95% CI: 0.662 - 1.260; P < 0.001]. Significant reductions were also observed in anxiety (SMD = 0.332; 95% CI: 0.146 - 0.517; P < 0.001) and depression (SMD = 0.766; 95% CI: 0.199 - 1.332; P = 0.008), along with improvements in sleep quality (SMD = 1.008; 95% CI: 0.411 - 1.602; P = 0.001). Due to the limited number of eligible studies, pooled analyses were conducted combining mindfulness and CBT interventions, without separate subgroup estimation. Conclusions: Mindfulness and CBT interventions can notably mitigate physical symptoms and mental health issues in menopausal patients with breast cancer, potentially ameliorating the side effects of pharmacological treatments.