Greater body mass index and adiposity are linked to adverse outcomes in women with breast cancer, including increased risk of recurrence and mortality, poorer quality of life, and increased risk of developing co-morbidities, such as type 2 diabetes, hypertension, and cardiovascular disease. The aim of this systematic review was to identify the ideal elements of effective behavioral lifestyle interventions treating obesity in breast cancer survivors.
A structured search for RCT studies published between database inception and March 2021 was conducted, on the four following databases: PubMed/Medline, Scopus, TripDatabase and Central/Cochrane. The search strategy included MeSH, Emtree terms and text words, using the PICO framework to guide the eligibility criteria. The PRISMA guidelines were followed. The risk of bias was assessed. The Behaviour Change Technique Taxonomy was used to identify the behaviour change techniques (BCTs) in the interventions.
Ten studies met the inclusion criteria. The ideal elements of an effective behavioral lifestyle intervention for weight control in breast cancer survivors were recorded as followed: a duration length at 6 months (n=7), in-person group sessions (n=6), Social Cognitive Theory as the most commonly used theory (n=7) and self-monitoring, goal setting and credible source as the best behavior change techniques (n=10). Lifestyle modification targets should include increased consumption of fruits, vegetables and fibre, decreased in dietary fat, a gradually increased exercise target of at least 30 minutes per day and a weight loss target of 1 lb per week through a 500-1000 kcal energy deficit.
Considering the unique needs of breast cancer survivors, weight management lifestyle interventions should include behaviors’ modifications in diet, physical activity and psychosocial factors with the use of behavioral therapy and suitable behavioural change techniques according to the characteristics of the most effective interventions. PROSPERO Registration Number CRD42021252827.