Positive affect and inflammation in women with breast cancer: A systematic review
In brief
Greater low-arousal positive affect linked to lower CRP in women with breast cancer
Six studies found that women reporting higher low-arousal positive emotions had reduced C-reactive protein levels, a marker of inflammation. Mindfulness-based interventions raised positive affect but showed mixed effects on IL-6 and CRP, while gene-expression analyses suggested a shift toward less pro-inflammatory activity. Larger, standardized trials are needed to confirm these associations.
- Journal
- Brain, behavior, & immunity - health (Q1)
- Published
- 13 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Michalina Frankowska, Mateusz Gliwinski, Magdalena Blazek
- PMID
- 42502425
- DOI
- 10.1016/j.bbih.2026.101305
Why clinicians should know about it
- Picked for Nephrology (top studies of the week, 2 August 2026).
- Picked for Biochemistry (medical) (paper of the day, 27 July 2026).
- Picked for Psychiatry and Mental Health (paper of the day, 27 July 2026).
- Picked for Oncology and Radiation Oncology (paper of the day, 27 July 2026): Positive affect and inflammation in breast cancer
Abstract
BACKGROUND: Positive affect has been implicated in psychobiological processes relevant to cancer adaptation and survivorship. However, evidence linking positive affect to objective inflammatory and immune-related biomarkers in women with breast cancer remains limited, fragmented, and methodologically heterogeneous. This systematic review was conducted to provide a focused and transparent synthesis of studies examining associations between positive affect and inflammatory or immune-related outcomes in this population. METHODS: Five electronic databases were systematically searched. The review protocol was prospectively registered in PROSPERO (CRD420261304159). Studies were included if they assessed positive affect using validated measures and reported at least one objective inflammatory or immune-related biomarker in women with breast cancer. Observational studies and randomized controlled trials were eligible. Six studies met predefined PICO criteria. RESULTS: Six studies examined associations between positive affect and inflammatory or immune-related outcomes across treatment and survivorship phases. Higher low-arousal positive affect was associated with lower C-reactive protein (CRP) in longitudinal analyses. Randomized controlled trials of Mindful Awareness Practices increased positive affect and meaning-related well-being; effects on circulating interleukin-6 (IL-6) and CRP were inconsistent, whereas transcriptional analyses indicated reduced or buffered pro-inflammatory gene expression. Increases in eudaimonic well-being were linked to reductions in conserved transcriptional response to adversity (CTRA) profiles. Affiliative positive emotions were associated with enhanced T helper type 1 (Th1)-type cytokine production. CONCLUSIONS: Current evidence suggests that positive affect may be associated with reduced inflammatory activity or more adaptive immune functioning in women with breast cancer. However, heterogeneity in affect conceptualization and biomarker assessment underscores the need for larger, methodologically harmonized longitudinal and intervention studies.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.