Long‐term psychological benefits of cognitive‐behavioral stress management for women with breast cancer: 11‐year follow‐up of a randomized controlled trial

• Published in: Cancer 2015-06, Vol.121 (11), p.1873-1881
• Main Authors: Stagl, Jamie M., Bouchard, Laura C., Lechner, Suzanne C., Blomberg, Bonnie B., Gudenkauf, Lisa M., Jutagir, Devika R., Glück, Stefan, Derhagopian, Robert P., Carver, Charles S., Antoni, Michael H.
• Format: Article
• Language: English
• Subjects: breast neoplasms; Breast Neoplasms - psychology; Breast Neoplasms - surgery; Breast Neoplasms - therapy; cognitive therapy; Cognitive Therapy - methods; depression; Female; Follow-Up Studies; Humans; Middle Aged; psychological stress; Psychotherapy - methods; Quality of Life; relaxation therapy; Single-Blind Method; Stress, Psychological - etiology; Stress, Psychological - therapy; Survivors
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.29076

BACKGROUND Breast cancer survivors experience long‐term physical and psychological sequelae after their primary treatment that negatively influence their quality of life (QOL) and increase depressive symptoms. Group‐based cognitive‐behavioral stress management (CBSM) delivered after surgery for early‐stage breast cancer was previously associated with better QOL over a 12‐month follow‐up and with fewer depressive symptoms up to 5 years after study enrollment. This 8‐ to 15‐year follow‐up (median, 11 years) of a previously conducted trial (NCT01422551) evaluated whether women in this cohort receiving CBSM had fewer depressive symptoms and better QOL than controls at an 8‐ to 15‐year follow‐up. METHODS Women with stage 0 to IIIb breast cancer were initially recruited 2 to 10 weeks after surgery and randomized to a 10‐week CBSM intervention or a 1‐day psychoeducational control group. One hundred women (51 CBSM patients and 49 controls) were recontacted 8 to 15 years after study enrollment to participate in a follow‐up assessment. The Center for Epidemiologic Studies–Depression (CES‐D) scale and the Functional Assessment of Cancer Therapy–Breast (FACT‐B) were self‐administered. Multiple regression was employed to evaluate group differences on the CES‐D scale and FACT‐B over and above effects of confounding variables. RESULTS Participants assigned to CBSM reported significantly lower depressive symptoms (d, 0.63; 95% confidence interval [CI], 0.56‐0.70) and better QOL (d, 0.58; 95% CI, 0.52‐0.65) above the effects of the covariates. CONCLUSIONS Women who received CBSM after surgery for early‐stage breast cancer reported lower depressive symptoms and better QOL than the control group up to 15 years later. Early implementation of cognitive‐behavioral interventions may influence long‐term psychosocial functioning in breast cancer survivors. Cancer 2015;121:1873–1881. © 2015 American Cancer Society. Women in a randomized controlled trial receiving cognitive‐behavioral stress management (CBSM) after surgery for early‐stage breast cancer are evaluated at an 8‐ to 15‐year follow‐up (median, 11 years). Women in the CBSM group report fewer depressive symptoms and better quality of life than a control group up to 15 years later.