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Practice Guideline
. 2025 Jun;18(2):e70029.
doi: 10.1111/jebm.70029.

Using Integrative Therapies to Improve Patient-Reported Outcomes in Breast Cancer Survivors: A Living Evidence-Based Clinical Practice Guideline

Tingting Lu  1 , Honghao Lai  2 , Hongsheng Lin  3 , Fei Ma  4 , Li Hou  5 , Lili Tang  6 , Yi Zhu  7 , Huijuan Mao  8 , Anthony Lin Zhang  9 , Myeong Soo Lee  10 , Akihiko Ozaki  11 , Mariana Cabral Schveitzer  12 , Hui Zhao  13 , Lidan Zhong  14 , Baohui Jia  3 , Lei Fan  3 , Jiajie Huang  15 , Baojin Han  3 , Weilong Zhao  2 , Long Ge  2 , Jie Liu  3 , Luqi Huang  13   16
Affiliations
Practice Guideline

Using Integrative Therapies to Improve Patient-Reported Outcomes in Breast Cancer Survivors: A Living Evidence-Based Clinical Practice Guideline

Tingting Lu et al. J Evid Based Med. 2025 Jun.

Abstract

Aim: Breast cancer imposes a serious disease and economic burden on patients. This guideline aims to develop a living evidence-based clinical practice recommendations to guide the use of integrative therapies for the improvement of patient-reported outcomes (PROs) in breast cancer survivors.

Methods: We searched systematic reviews and meta-analyses or conducted de nova systematic reviews and meta-analyses to support the recommendations. The grading of recommendations, assessment, development, and evaluation approach was used to rate the certainty of evidence and the strength of recommendations.

Results: The guideline panel issued 17 recommendations: for alleviating anxiety, strong recommendations in favor of muscle relaxation training, yoga, acceptance and commitment therapy, cognitive behavioral therapy, psychological education, and Tai Chi in general breast cancer survivors; for alleviating depression, strong recommendations in favor of mindfulness therapy, cognitive behavioral therapy, group psychotherapy, muscle relaxation training, acceptanceand commitment therapy in general breast cancer survivors, and exercise intervention for patients received radiotherapy; for sleep quality, conditional recommendations for all therapies; for pain, strong recommendations in favor of exercise intervention for postoperative breast cancer survivors; for alleviating fatigue, strong recommendations in favor of mindfulness therapy and group psychotherapy in general breast cancer survivors; for improving the quality of life, strong recommendations in favor of mindfulness therapy in general breast cancer survivors, Baduanjin and exercise intervention for patients undergoing anticancer treatment.

Conclusion: This proposed guideline provides recommendations for improving the PROs of breast cancer survivors. We hope these recommendations can help support practicing physicians and other healthcare providers for breast cancer survivors.

Keywords: breast cancer survivors; clinical practice guideline; integrative therapies; patient‐reported outcomes.

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Conflict of interest statement

The authors declare no conflicts of interest.

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References

    1. Sung H., Ferlay J., Siegel R. L., et al., “Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries,” CA: A Cancer Journal for Clinicians 71, no. 3 (2021): 209–249. - PubMed
    1. Thun M. J., Linet M. S., Cerhan J. R., Haiman C. A., and Schottenfeld D., Cancer Epidemiology and Prevention (Oxford University Press, 2017).
    1. Lei S., Zheng R., Zhang S., et al., “Global Patterns of Breast Cancer Incidence and Mortality: A Population‐Based Cancer Registry Data Analysis From 2000 to 2020,” Cancer Communications 41, no. 11 (2021): 1183–1194. - PMC - PubMed
    1. Lyman G. H., Greenlee H., Bohlke K., et al., “Integrative Therapies During and After Breast Cancer Treatment: ASCO Endorsement of the SIO Clinical Practice Guideline,” Journal of Clinical Oncology 36, no. 25 (2018): 2647–2655. - PubMed
    1. CAM Definitions | About CAM | Health Information | OCCAM, https://cam.cancer.gov/health_information/cam_definitions.htm.

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