Psychological distress, fear of recurrence, anxiety and depressive symptoms are common among women who have survived breast cancer. A systematic review concludes that the interventions that work best are multimodal, theory-based and delivered by trained professionals, whereas purely cognitive approaches or minimally structured digital programmes show no clear benefit.
What was already known
Rising incidence and, above all, improved survival have increased the number of survivors living with psychological distress. That distress often blends anxiety, depression and fear of recurrence. Many interventions overlook each survivor’s particular psychosocial context, and loose definitions of “distress” make it hard to measure and to compare results across studies.
What this work adds
The authors followed PRISMA guidelines and searched six databases for randomised controlled trials of distress interventions in breast cancer survivors published between 2014 and July 2025. They assessed methodological quality with Cochrane’s RoB 2 tool and extracted data on each intervention’s characteristics, outcomes and measurement instruments.
Main results
Fourteen trials involving 2,447 survivors were included. Eight of them (57%) reported significant reductions in distress: six showed an effect immediately after the intervention and two only at follow-up. Effect sizes ranged from small to large (Cohen’s d between 0.44 and 1.54). Mindfulness-based interventions, virtual reality-integrated psychotherapy and cognitive-behavioural therapy combined with hypnosis were effective. By contrast, cognitive-focused interventions lacking experiential components and minimally structured digital programmes showed no significant results.
What it means
The message for patients and breast units is that not every kind of psychological support works equally well. Programmes with a solid theoretical basis, several active components and trained professionals achieve better results than self-managed apps without support. The authors call for better definitions of distress, standardised instruments and more attention to younger survivors, who remain under-represented. Digital platforms improve access, but they only work if their content is evidence-based and their delivery is well structured.
Reading from a breast unit
In practice, this supports standardising distress detection with validated instruments and offering structured programmes with professional support, rather than referring patients to unsupervised digital resources.
Reference: An H, Kim Y. Managing psychological distress in women with breast cancer: A systematic review of intervention trends in the past decade. Asia-Pacific journal of oncology nursing, 2026. DOI: 10.1016/j.apjon.2025.100826
