For women with metastatic breast cancer (cancer that has spread beyond the breast) several types of psychological interventions may be available. These include educational and psychotherapeutic interventions, support groups and individual cognitive behavioural treatment (treatment that helps people test and revise their thoughts, attitudes and actions). One promising study conducted in 1989 appeared to show significant survival benefits as well as psychological benefits from a psychological intervention given to women with metastatic breast cancer. These results however were never replicated despite another four trials being conducted (including one by members of the first study group).
For this review a comprehensive search was conducted. Five primary studies of group psychological interventions were identified involving 511 women. Two of these were cognitive behavioural interventions and three evaluated support-expressive group therapy. The five studies of group psychological therapies showed very limited evidence of benefit arising from these interventions. Although psychological interventions were shown to provide some short-term psychological benefits, this benefit was not sustained for longer than a few months. The studies in this review all used a wide variety of outcome measures and periods of follow-up for the trial participants which may have contributed to a lack of conclusive results. Although one trial showed an increase in survival from support group participation, all the other trials found no benefit. Therefore at this time there is insufficient evidence to advocate that group psychological therapies (either cognitive behavioural or supportive-expressive) should be made available to women diagnosed with metastatic breast cancer. Any benefits of the interventions are only evident for some of the psychological outcomes reviewed and in the short term. The possibility of the interventions causing harm is also not ruled out by the available data.