Effects of yoga on depressive symptoms in breast cancer patients: a meta-analysis of randomized controlled trials

Clinical Snapshot

Key Findings

• P Value: P < 0.00001

• Effect Size: SMD = -0.58 (moderate effect size favouring yoga)

• Primary Outcome: Depressive symptoms measured by validated depression scales

• Nnt Or Sensitivity: Moderate effect size suggests clinically meaningful improvement; postoperative radiotherapy group showed largest benefit (SMD: -2.47)

• Confidence Interval: 95% CI (-0.83, -0.32)

Clinical Application

Yoga is generally accessible and low-risk; requires qualified instructors and patient willingness to participate Aligns with Cancer Australia's supportive care guidelines; may be covered under some private health insurance; RACGP supports complementary therapies with evidence base Breast cancer patients across treatment phases, particularly those receiving postoperative radiotherapy

Abstract

BACKGROUND: While yoga is known to benefit depression in breast cancer patients, its efficacy as an adjunct to diverse treatment regimens remains unclear. This study evaluated yoga's efficacy in alleviating depression during varied breast cancer therapies and supports its clinical integration as a complementary intervention. METHODS: Following PRISMA 2020 guidelines, we systematically searched for RCTs in English and Chinese. Literature quality was assessed using the Cochrane Risk of Bias tool. Data were analyzed with Review Manager 5.4.1, including subgroup analyses by treatment type and assessment scale. RESULTS: Analysis of 21 studies showed yoga significantly reduced depression levels [SMD = -0.58, 95% CI (-0.83, -0.32), P < 0.00001]. Subgroup analyses revealed a significant combined mean difference among the surgery group [SMD: -1.04], the postoperative radiotherapy group [SMD: -2.47], and the postoperative chemotherapy group [SMD: -0.46]. The group receiving postoperative radiotherapy demonstrated a significantly greater improvement in depression. Subgroup analyses of scale-assessed effects confirmed the validity of the Beck Depression Inventory (BDI), the Center for Epidemiologic Studies Depression Scale (CESD), the Hospital Anxiety and Depression Scale (HADS), and the Zung Self-Rating Depression Scale (SDS). The HADS demonstrated a greater effect size [SMD = -1.19, 95% CI (-2.13, -0.24), P = 0.01]. CONCLUSIONS: The impact varied among those undergoing different treatment regimens. Notably, the degree of improvement in depression appeared to be greater in the postoperative radiotherapy group. HADS is a practical self-assessment scale that has demonstrated considerable improvement and is recommended for use in breast cancer patients with depression.

References

1. 1.Li, Y., Wang, J., Wang, Z., Yun, J., Yang, Y., Yang, X., Xiao, X., & Ren, C. (2026). Effects of yoga on depressive symptoms in breast cancer patients: a meta-analysis of randomized controlled trials. Supportive Care in Cancer. https://doi.org/10.1016/j.bbi.2015.06.012