{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T13:30:57Z","timestamp":1772199057648,"version":"3.50.1"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"\n Background<\/jats:title>\n Fear of cancer recurrence (FCR) is a highly prevalent and clinically significant psychological concern among breast cancer patients, which can substantially impair their physical and psychological well-being. Emerging evidence suggests that psychotherapeutic interventions exert heterogeneous effects on FCR and psychological resilience in this patient population; however, a paucity of comprehensive network meta-analyses has systematically compared the relative efficacy of diverse psychotherapies for FCR in breast cancer survivors. The present network meta-analysis was conducted to systematically evaluate and compare the effectiveness of various mind-body interventions in mitigating FCR and enhancing psychological resilience among breast cancer patients.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Randomized controlled trials (RCTs) on different psychotherapeutic methods for psychological problems such as the fear of cancer recurrence, anxiety, and depression in breast cancer patients were retrieved by computer from PubMed, Embase, Cochrane Library, Web of Science, CNKI (China National Knowledge Infrastructure), VIP Database for Chinese Technical Periodicals, Wanfang Data Knowledge Service Platform, and Chinese Biomedical Literature Database. To ensure the novelty of the research, the retrieval time limit was set from January 2019 to March 2025. Two researchers screened the literature, extracted the data, and evaluated the methodological quality according to the inclusion and exclusion criteria. Network meta-analysis was conducted using RevMan 5.4 and Stata 17.0.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Nineteen eligible randomized controlled trials (RCTs) involving 11 interventions and 2214 participants were included. Network meta-analysis indicated distinct psychotherapeutic approaches had superior efficacy for specific psychological outcomes: couple skills training showed probabilistic advantages for fear of cancer recurrence (FCR, Fear of Cancer Recurrence Inventory); narrative therapy was effective for recurrence-related concerns; cognitive behavioral therapy (CBT) had probabilistic benefits in reducing fear of progression (Fear of Progression Questionnaire-Short Form) and enhancing positive psychological capital (Positive Psychological Capital Questionnaire); and both CBT and mindfulness therapy outperformed other interventions for anxiety and depression (Hospital Anxiety and Depression Scale). Sensitivity and subgroup analyses further validated the robustness of the findings and explored sources of heterogeneity. Subgroup analysis identified measurement time points and treatment status as the primary contributors to substantial overall heterogeneity (I\u00b2=91.9%, P&lt;0.001), whereas measurement tools had no notable effect;leave-one-out sensitivity analysis showed the pooled effect size stably ranged from -1.44 to -0.63, with no single study driving overall results, confirming the robustness of core conclusions.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Our findings underscore the outcome-specific advantages of different psychotherapeutic interventions for breast cancer patients, thereby supporting the adoption of a personalized, needs-based approach to address FCR, psychological distress, and resilience. Nevertheless, the current evidence is constrained by substantial heterogeneity in intervention protocols, variability in outcome measurement tools, and a relatively limited number of trials for certain interventions. Future high-quality RCTs with standardized intervention protocols, consistent outcome metrics, and long-term follow-up are warranted to validate these findings and inform the development of clinical practice guidelines for psychological support in breast cancer survivors.<\/jats:p>\n <\/jats:sec>\n \n Systematic review registration<\/jats:title>\n \n https:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/jats:ext-link>\n , identifier CRD420251009772.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fonc.2026.1597317","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T12:53:37Z","timestamp":1772196817000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of the effects of cognitive-supportive-relaxation multimodal psychosocial intervention on fear of cancer recurrence and psychological resilience in breast cancer patients: a network meta-analysis based on randomized controlled trials"],"prefix":"10.3389","volume":"16","author":[{"given":"Yuan","family":"Jiankun","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Xiaojuan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wang","family":"Liyi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dai","family":"Xuejun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deng","family":"Aihua","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"He","family":"Lang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA: A Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1111\/jan.15321","article-title":"The effect of psychological interventions on fear of cancer recurrence in breast cancer survivors: A systematic review and meta-analysis","volume":"78","author":"Lyu","year":"2022","journal-title":"J Adv Nurs"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/jan.16369","article-title":"Role of peer support on fear of cancer recurrence in patients with breast cancer","volume":"81","author":"Wang","year":"2024","journal-title":"J Adv Nurs"},{"key":"B4","first-page":"67","article-title":"The relationship between self-compassion and fear of cancer recurrence in Chinese breast cancer patients: The mediating role of maladaptive cognitive styles","volume":"31","author":"Guo","year":"2024","journal-title":"J Nurs (China)"},{"key":"B5","article-title":"Cochrane handbook for systematic reviews of interventions","volume-title":"International Coaching Psychology Review","author":"Assem","year":"2020"},{"key":"B6","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1002\/jrsm.1167","article-title":"Automated generation of node-splitting models for assessment of inconsistency in network meta-analysis","volume":"7","author":"Van Valkenhoef","year":"2016","journal-title":"Res Synth Methods"},{"key":"B7","article-title":"The influence of PERMA positive psychological intervention on the rehabilitation psychology of young breast cancer patients","volume":"22","author":"Wang","year":"2024","journal-title":"Chin Gen Pract Nurs"},{"key":"B8","article-title":"Self-disclosure intervention for breast cancer patients undergoing chemotherapy after surgery","volume":"37","author":"Chen","year":"2022","journal-title":"J Nurs Sci"},{"key":"B9","article-title":"The application effect of positive psychological intervention based on the happiness PERMA model in the nursing of young and middle-aged breast cancer patients","volume":"19","author":"Dong","year":"2022","journal-title":"Health Med Res Prac"},{"key":"B10","article-title":"Application of narrative therapy-based nursing intervention in fear of recurrence among breast cancer patients undergoing chemotherapy","volume":"20","author":"Gao","year":"2022","journal-title":"Chin Gen Pract Nurs"},{"key":"B11","doi-asserted-by":"publisher","first-page":"459","DOI":"10.16821\/j.cnki.hsjx.2022.05.017","article-title":"Effect of cognitive behavioral stress management on fear of recurrence in young patients after breast cancer surgery","volume":"37","author":"Deng","year":"2022","journal-title":"J Nurs Training"},{"key":"B12","volume-title":"A study on the intervention effect of mindfulness-based stress reduction therapy on the fear of cancer recurrence in breast cancer patients","author":"Wang","year":"2021"},{"key":"B13","article-title":"Application of PERMA model-based nursing intervention in elderly patients with breast cancer","volume":"35","author":"Dong","year":"2021","journal-title":"Chin Nurs Res"},{"key":"B14","volume-title":"The influence of positive psychological intervention under the PERMA model on the fear of cancer recurrence in breast cancer patients","author":"Wang","year":"2021"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.13455\/j.cnki.cjcor.2021.02.26","article-title":"The influence of mindfulness relaxation training on the fear of cancer recurrence, cancer-related fatigue, and sleep quality in breast cancer\u00a0patients","volume":"28","author":"Wang","year":"2021","journal-title":"Chin J Clin Oncol Rehabil"},{"key":"B16","volume-title":"A study on the current situation of the fear of recurrence and the intervention effect in breast cancer patients during the chemotherapy period after surgery","author":"Zhou","year":"2020"},{"key":"B17","article-title":"Application of couple self-disclosure in intervention for fear of cancer recurrence in young patients with breast cancer","volume":"54","author":"Zhang","year":"2019","journal-title":"Chin J Nurs"},{"key":"B18","doi-asserted-by":"publisher","first-page":"102459","DOI":"10.1016\/j.ejon.2023.102459","article-title":"Couples\u2019 skills training intervention in young breast cancer patients with fear of cancer recurrence: A randomized controlled trial","volume":"67","author":"Cheng","year":"2023","journal-title":"Eur J Oncol Nurs"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1002\/pon.6193","article-title":"ConquerFear-Group: A randomized controlled trial of an online-delivered group-based psychological intervention for fear of cancer recurrence in breast cancer survivors","volume":"32","author":"Tauber","year":"2023","journal-title":"Psycho-Oncology"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.19591","article-title":"Effect of a nurse navigation intervention on mental symptoms in patients with psychological vulnerability and breast cancer: the REBECCA randomized clinical trial","volume":"6","author":"Bidstrup","year":"2023","journal-title":"JAMA Netw Open"},{"key":"B21","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1002\/pon.6105","article-title":"Improving emotion regulation in breast cancer patients in the early survivorship period: Efficacy of a brief ecologically boosted group intervention","volume":"32","author":"Merckaert","year":"2023","journal-title":"Psychooncology"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1002\/pon.6097","article-title":"Internet-delivered cognitive behavioural therapy for depression and anxiety in breast cancer survivors: Results from a randomised controlled trial","volume":"32","author":"Akkol-Solakoglu","year":"2023","journal-title":"Psycho-Oncology"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.22.00699","article-title":"Smartphone psychotherapy reduces fear of cancer recurrence among breast cancer survivors: A fully decentralized randomized controlled clinical trial (J-SUPPORT 1703 study)","volume":"41","author":"Akechi","year":"2023","journal-title":"J Clin Oncol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"101686","DOI":"10.1016\/j.ctcp.2022.101686","article-title":"Effects of an online mindfulness-based intervention on Fear of Cancer Recurrence and quality of life among Chinese breast cancer survivors","volume":"49","author":"Peng","year":"2022","journal-title":"Complement Ther Clin Prac"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.02.017","article-title":"Mindfulness-based cognitive therapy for psychological distress, fear of cancer recurrence, fatigue, spiritual well-being, and quality of life in patients with breast cancer-A randomized controlled trial","volume":"60","author":"Park","year":"2020","journal-title":"J Pain Sympt Manag"},{"key":"B26","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1186\/s12888-025-06546-4","article-title":"Association among financial toxicity, depression and fear of cancer recurrence in young breast cancer patient-family caregiver dyads: an actor-partner interdependence mediation model","volume":"25","author":"Yang","year":"2025","journal-title":"BMC Psychiatry"},{"key":"B27","doi-asserted-by":"publisher","first-page":"111177","DOI":"10.1016\/j.jpsychores.2023.111177","article-title":"Predictors and trajectories of fear of cancer recurrence in Chinese breast cancer patients","volume":"166","author":"Yang","year":"2023","journal-title":"J Psychosom Res"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2022.864129","article-title":"Social support and fear of cancer recurrence among chinese breast cancer survivors: the mediation role of illness uncertainty","volume":"13","author":"Yu","year":"2022","journal-title":"Front Psychol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2021.835","article-title":"Fear of cancer recurrence and its negative impact on health-related quality of life in long-term breast cancer survivors","volume":"54","author":"Tran","year":"2022","journal-title":"Cancer Res Treat"},{"key":"B30","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s40359-025-02353-4","article-title":"The influence of locus of control, coping strategies and time perspective on post-traumatic growth in survivors with primary breast cancer","volume":"13","author":"Paunescu","year":"2025","journal-title":"BMC Psychol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1097\/NCC.0000000000000455","article-title":"Fear of recurrence as a predictor of care needs for long-term breast cancer survivors","volume":"41","author":"Fang","year":"2018","journal-title":"Cancer Nurs"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5727","article-title":"The relationships between fear of cancer recurrence, spiritual well-being and psychological resilience in non-metastatic breast cancer survivors during the COVID-19 outbreak","volume":"30","author":"Koral","year":"2021","journal-title":"Psycho-Oncology"},{"key":"B33","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1186\/s12885-021-08909-y","article-title":"Cognitive behavioral therapy for reducing fear of cancer recurrence (FCR) among breast cancer survivors: a systematic review of the literature","volume":"22","author":"Park","year":"2022","journal-title":"BMC Cancer"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.1030630","article-title":"The efficacy of cognitive behavioral therapy for cancer: A scientometric analysis","volume":"13","author":"Lin","year":"2022","journal-title":"Front Psychiatry"},{"key":"B35","doi-asserted-by":"publisher","first-page":"84","DOI":"10.23736\/S0026-4806.16.04528-6","article-title":"Effects of cognitive behavioral therapy on quality of life and stress for breast cancer survivors: a meta-analysis","volume":"108","author":"Zhang","year":"2017","journal-title":"Minerva Med"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.13898\/j.cnki.issn.1000-2200.2022.11.027","article-title":"The relationship among the fear of cancer recurrence after breast cancer surgery, couple support, and quality of life","volume":"47","author":"Pan","year":"2022","journal-title":"J Bengbu Med Coll"},{"key":"B37","doi-asserted-by":"publisher","first-page":"102837","DOI":"10.1016\/j.ejon.2025.102837","article-title":"Factors affecting resilience among young breast cancer survivors: A cross-sectional study","volume":"75","author":"Min","year":"2025","journal-title":"Eur J Oncol Nurs"},{"key":"B38","first-page":"397","article-title":"Research progress on the application of self-disclosure in the intervention of people after trauma","volume":"15","author":"Niu","year":"2017","journal-title":"Chin Gen Pract Nurs"},{"key":"B39","article-title":"Research progress and inspiration of self-disclosure intervention for cancer patients abroad","volume":"39","author":"Zhang","year":"2018","journal-title":"Med Philos (B)"},{"key":"B40","doi-asserted-by":"publisher","first-page":"388","DOI":"10.16128\/j.cnki.1005-3611.2019.02.036","article-title":"The influence of self-disclosure on benefit finding in breast cancer patients: The chain mediating role of intimate relationship and self-efficacy","volume":"27","author":"Wu","year":"2019","journal-title":"Chin J Clin Psychol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1200\/jgo.18.57500","article-title":"Narrative therapy and hope in breast cancer patients","volume":"4","author":"Sajadian","year":"2018","journal-title":"J Gynecol Oncol"},{"key":"B42","article-title":"A scoping review of the application of narrative therapy in breast cancer patients","volume":"58","author":"Xia","year":"2023","journal-title":"Chin J Nurs"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol28040249","article-title":"Narratives of survivorship: A study of breast cancer pathographies and their place in cancer rehabilitation","volume":"28","author":"Mohlin","year":"2021","journal-title":"Curr Oncol"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1080\/0284186X.2017.1342862","article-title":"Mindfulness-based interventions for women with breast cancer: an updated systematic review and meta-analysis","volume":"56","author":"Haller","year":"2017","journal-title":"Acta Oncol"},{"key":"B45","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1007\/s10865-021-00214-0","article-title":"Mindfulness-based stress reduction for breast cancer survivors (MBSR(BC)): evaluating mediators of psychological and physical outcomes in a large randomized controlled trial","volume":"44","author":"Lengacher","year":"2021","journal-title":"J Behav Med"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1201","article-title":"Network meta-analysis for indirect treatment comparisons","volume":"21","author":"Lumley","year":"2002","journal-title":"Stat Med"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1597317\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T12:53:44Z","timestamp":1772196824000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1597317\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,27]]},"references-count":46,"alternative-id":["10.3389\/fonc.2026.1597317"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1597317","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,27]]},"article-number":"1597317"}}