Digital and AI-enhanced psychosocial interventions in breast cancer patients: a systematic review and meta-analysis
Clinical Snapshot
PICO Framework
| P — Population | Women with breast cancer experiencing psychological distress |
| I — Intervention | Digital and AI-enhanced psychosocial interventions (cognitive behavioural therapy, mindfulness, psychoeducation) |
| C — Comparator | Control groups (usual care, waitlist, or attention control) |
| O — Outcomes | Stress, anxiety, depression, and health-related quality of life (HRQoL) |
Bottom Line
This systematic review of 35 RCTs involving 7,551 breast cancer patients suggests digital and AI-enhanced psychosocial interventions produce modest but consistent improvements in psychological distress and quality of life. Interventions based on cognitive behavioural therapy, mindfulness, or psychoeducation showed the most reliable benefits, with AI-assisted formats outperforming static platforms. However, evidence certainty remains moderate due to methodological limitations including heterogeneous intervention designs, short follow-up periods, and predominance of small single-centre studies. While these interventions show promise as adjuncts to conventional care and may improve access to supportive services, the authors appropriately conclude that larger, multicentre trials with longer follow-up are needed before informing clinical guidelines or widespread implementation. Clinicians should view these tools as potentially useful supplements to standard psychosocial support rather than replacements.
Key Findings
P Value: Not specified in abstract
Effect Size: Standardised mean differences (Hedges' g) - specific values not provided in abstract
Primary Outcome: Modest but consistent reductions in stress, anxiety, and depressive symptoms with improvements in health-related quality of life
Nnt Or Sensitivity: CBT, mindfulness, and psychoeducation-based interventions showed most reliable outcomes
Confidence Interval: Not specified in abstract
Clinical Application
High feasibility as adjunct to conventional care, may improve access to supportive oncology services Relevant to Australian practice given PBS coverage for psychological services and TGA regulation of digital therapeutics. Aligns with RACGP guidelines for integrated cancer care Women with breast cancer experiencing psychological distress, particularly those with access to digital platforms
Abstract
PURPOSE: Digital and AI-supported psychosocial interventions are increasingly implemented to address psychological distress among women with breast cancer. However, their effectiveness and sustainability remain uncertain. This review aimed to systematically evaluate randomised controlled trials (RCTs) assessing the impact of digital and AI-enhanced psychosocial interventions on stress, anxiety, depression, and health-related quality of life (HRQoL). METHODS: Following PROSPERO registration and PRISMA 2020 guidelines, comprehensive searches of multiple databases were conducted up to June 2025. Eligible studies included RCTs involving breast cancer populations and reporting validated psychosocial outcomes. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and certainty of evidence was evaluated with GRADE. Random-effects meta-analyses using standardised mean differences (Hedges' g) were conducted to pool outcomes measured with different instruments. RESULTS: Thirty-five RCTs (n ≈ 7551 participants) met inclusion criteria. Pooled analyses indicated modest but consistent reductions in stress, anxiety, and depressive symptoms, alongside improvements in HRQoL. Interventions grounded in cognitive behavioural therapy, mindfulness, or psychoeducation produced the most reliable outcomes. AI-assisted and blended formats tended to show stronger effects compared with static or minimally interactive platforms. However, heterogeneity in intervention design, short follow-up periods, reliance on self-reported outcomes, and small single-centre samples limited certainty. Cultural adaptation and representation from low- and middle-income countries were minimal. CONCLUSION: Digital and AI-supported psychosocial interventions show promise in reducing distress and improving HRQoL among women with breast cancer. Evidence certainty remains moderate, constrained by methodological limitations. Larger, multicentre trials with longer follow-up and diverse populations are needed to establish sustainability, generalisability, and clinical integration. RELEVANCE: These findings suggest that digital and AI-enhanced psychosocial interventions may serve as adjuncts to conventional care, with potential to improve access to supportive oncology services. Further high-quality, long-term studies are needed before informing guidelines, policy, or widespread implementation. TRIAL REGISTRATION: PROSPERO (CRD420251074813; registered 16 June 2025).
References
- 1.Anto, B., Simon, K. M., & Haroon, A. P. (2026). Digital and AI-enhanced psychosocial interventions in breast cancer patients: a systematic review and meta-analysis. Supportive Care in Cancer. https://doi.org/10.1146/annurev-psych-032420-031047
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