Digital Health Interventions and Psychosocial Outcomes in Women With Breast Cancer: Systematic Review

Why clinicians should know about it

• Picked for Dermatology (top studies of the week, 23 August 2026): Digital health for breast cancer, not dermatology

Abstract

BACKGROUND: Breast cancer and its treatment can negatively affect women's quality of life (QoL), including physical, psychological, and social well-being. Digital health interventions have been increasingly used to provide supportive care, but their effectiveness on QoL and related psychosocial outcomes remains unclear. OBJECTIVE: This review aimed to evaluate the effectiveness of digital health interventions on QoL in women with breast cancer and to assess their effects on anxiety, depression, and self-efficacy. METHODS: This systematic review was registered in PROSPERO (CRD420250578307) and conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. PsycINFO, Web of Science, Scopus, LILACS, and SciELO were searched in September 2025. Eligible studies were randomized controlled trials (RCTs) or controlled quasi-experimental studies with preintervention and postintervention assessments that evaluated digital health interventions in women with breast cancer during or up to 1 year after active treatment and reported QoL outcomes. Two reviewers independently screened all records (interrater agreement >90%) and extracted data using a standardized template, with independent verification by a second reviewer. Risk of bias was assessed using the Cochrane Risk of Bias tool (RoB 2) for RCTs and the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool for the quasi-experimental study; findings were synthesized narratively following the Synthesis Without Meta-analysis (SWiM) guideline. RESULTS: A total of 408 records were identified, and 15 studies were included: 14 RCTs and 1 quasi-experimental study. Sample sizes ranged from 35 to 394 participants. Ten studies evaluated internet-based approaches such as websites or apps; 3 used text messaging (eg, WhatsApp [WhatsApp LLC] or WeChat [Tencent Technology, Shenzhen Company Limited]), 1 used virtual reality, and 1 used an email listserve. The direction of effect favored the digital intervention for QoL in 8 of the 15 studies. Self-efficacy was assessed in 5 studies and favored the intervention in only 1, with the effect not maintained at follow-up. Anxiety, depression, or emotional distress were assessed in 13 studies, with a favorable direction of effect in 5. Retention rates ranged from 68.6% to 100%. Among the 14 RCTs, 3 were judged at high overall risk of bias, and 11 raised some concerns; none was at low risk. The quasi-experimental study had a serious overall risk of bias. Certainty of evidence was low for QoL and emotional outcomes and very low for self-efficacy. CONCLUSIONS: Digital health interventions may provide modest, short-term improvements in some dimensions of QoL in women with breast cancer. Favorable effects appeared more often in interventions with active therapeutic components or professional support; however, this pattern was based on indirect comparisons across heterogeneous studies. Effects on self-efficacy and mental health were inconsistent, and acceptability was insufficiently evaluated. Although promising, current evidence does not support strong or generalizable conclusions.

Abstract as published, via PubMed.