Effects of an online mindfulness-based intervention on Fear of Cancer Recurrence and quality of life among Chinese breast cancer survivors.

OBJECTIVE: Mindfulness-based interventions (MBIs) targeting cancer-related emotions and quality of life have attracted extensive attention in recent years. The purpose of the current study was to assess the feasibility and acceptability of an online mindfulness-based intervention and examine its effects on Chinese breast cancer survivors. METHODS: Sixty-five breast cancer survivors were randomized to either an online MBI or to wait for the next available program. The control group received usual care, while the intervention group also received six weeks of online MBI training. Participants completed the Short Form of the Fear of Cancer Recurrence Inventory (FCRI-SF), Five Facet Mindfulness Questionnaire (FFMQ) and European Organization for Research and Treatment of Cancer questionnaire (EORTC-QLQ-C30) at baseline (T1), immediately after the intervention (postintervention: T2) and 1 month later (1-month postintervention: T3). In addition, answers provided to questions about the experience of participating in the course were analyzed. RESULTS: Compared with the control group, the mindfulness, emotional and cognitive function of the MBI group was significantly improved after the intervention, and the FCR of breast cancer survivors was significantly alleviated. These effects were still significant 1 month after the end of the intervention. Additionally, participants were satisfied with the online MBI through the qualitative survey. CONCLUSION: This online MBI showed promise for Chinese breast cancer survivors, facilitating a reduction in FCR and improving their quality of life. The results of our study indicated that online MBI treatment could offer a scalable approach to manage FCR and maintain mental health for breast cancer survivors.

Association of Long-term Oncologic Prognosis With Minimal Access Breast Surgery vs Conventional Breast Surgery.

Importance: Minimal access breast surgery (MABS) has been used in breast cancer management. However, long-term prognostic data associated with MABS vs conventional breast surgery (CBS) are lacking. Objective: To investigate long-term therapeutic outcomes associated with MABS vs CBS for breast cancer management. Design, Setting, and Participants: In this single-center retrospective cohort study, 9184 individuals were assessed for inclusion. After exclusions, 2412 adult female individuals were included who were diagnosed with stage 0 to III breast cancer, underwent unilateral breast surgery between January 2004 and December 2017, and had no distant metastasis or history of severe underlying disease. Propensity score matching was performed to minimize selection bias. Data were analyzed from January 1, 2004, to December 31, 2019. Exposures: MABS or CBS. Main Outcomes and Measures: Data on demographic and tumor characteristics and long-term outcomes were collected and analyzed. Results: This study included 2412 patients (100% female; median [IQR] age, 44 [40-49] years). Of these, 603 patients underwent MABS (endoscopic, endoscopy-assisted, or robot-assisted procedures in 289, 302, and 12 patients, respectively) and 1809 patients underwent CBS. The median follow-up time was 84 months (93 in the MABS group and 80 months in the CBS group). Intergroup differences were not significant for the following parameters: 10-year local recurrence-free survival (93.3% vs 96.3%; hazard ratio [HR], 1.39; 95% CI, 0.86-2.27; P = .18), regional recurrence-free survival (95.5% vs 96.7%; HR, 1.38; 95% CI, 0.81-2.36; P = .23), and distant metastasis-free survival (81.0% vs 82.0%; HR, 0.95; 95% CI, 0.74-1.23; P = .72). The 5-, 10-, and 15-year disease-free survival rates in the MABS group were 85.9%, 72.6%, and 69.1%, respectively. The corresponding rates in the CBS group were 85.0%, 76.6%, and 70.7%. The intergroup differences were not significant (HR, 1.07; 95% CI, 0.86-1.31; P = .55). The 5-, 10-, and 15-year overall survival rates in the MABS group were 92.0%, 83.7%, and 83.0%, respectively. The corresponding rates in the CBS group were 93.6%, 88.7%, and 81.0%. The intergroup differences were not significant (HR, 1.29; 95% CI, 0.97-1.72; P = .09). Post hoc subgroup analysis showed no significant intergroup differences in disease-free survival. Conclusions and Relevance: In this cohort study, long-term outcomes following MABS were not significantly different from those following CBS in patients with early-stage breast cancer. MABS may be a safe and feasible alternative in this patient population.