Preoperative Relaxation Techniques for Breast Cancer Patients Undergoing Breast-Altering Surgery: A Systematic Review

Context: Preoperative relaxation techniques and complementary alternative treatments being used with breast cancer patients undergoing breast-altering surgery.

Objective: To examine the effectiveness of preoperative relaxation techniques to decrease anxiety in breast cancer patients undergoing breast-altering surgery.

Data Sources: A systematic review of English articles used the PubMed, Embase, and CINAHL databases. Searching bibliographies identified additional studies.

Study selection: Six interventional research studies met the criteria for this specific patient population. Inclusion criteria included interventional studies within the last 10 years written in English, women 18 years old and over, either diagnosed or suspected breast cancer undergoing breast-altering surgery. Implementation strategies including music therapy, stress management training, informational and emotional support sessions, an informational video, and hypnosis were examined.

Results: The 6intervention studies reviewed included 462 women, ages 18 and older. Effective intervention employed to reduce anxiety symptoms among preoperative breast cancer patients included informational and emotional support programs, music, and hypnosis. Stress-management training and videotaped information did not result in a significant decrease in anxiety symptoms.

Conclusion: There is scant research to draw on to determine the optimal approach to decrease preoperative anxiety for this patient population. Four of the 6 studies examined reported a decrease in anxiety; however, the interventions and measurement of anxiety symptoms varied across studies. More research is needed to study the effects of relaxation techniques and the best time to incorporate these techniques for breast cancer patients undergoing breast-altering operative procedures.

Keywords: Preoperative; Relaxation technique; Complementary alternative therapy; Complementary alternative medicine; Breast cancer; Surgery

Abbreviations: M:Mean; N; Total Sample Size; n: Sub-Sample Size; ASA: American Society of Anesthesiologists ; COPD: Chronic Obstructive Pulmonary Disease; SSAS: State Anxiety Scale; VAS: Visual Analog Scale; PACU: Post-anesthesia Care Unit; CMSAS-M: Condensed Memorial Symptom Assessment Scale- Modified; POMS: Profile of Mood States; DI: Demographic Inventory; BIS: Body Image Scale ; A-VAS: Anxiety-Visual Analog Scale, T1, T2, T3: Time 1, Time 2, Time 3