The Role of Social Support in Quality of Life After Mastectomy for Breast Cancer: A Systematic Review
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Abstract
Objective:
Breast cancer survival rates continue to improve; however, mastectomy can substantially affect quality of life (QoL) across physical, psychological, and social domains. This systematic review evaluated the association between social support interventions and QoL outcomes among women who underwent mastectomy without reconstruction, regardless of surgical technique.
Methods:
A systematic search of MEDLINE (PubMed), Embase, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL), along with manual reference screening, was conducted through April 29, 2025. Eligible studies included randomized and nonrandomized designs evaluating social support interventions and QoL using validated instruments. Risk of bias was assessed using the Cochrane Risk of Bias tool for randomized trials and the Newcastle–Ottawa Scale for observational studies.
Results:
Fifteen studies involving 1,546 participants met the inclusion criteria. Interventions varied widely and included peer support groups, psychological counseling, family-centered programs, and digital or technology-mediated platforms. Thirteen of the fifteen studies (87%) reported statistically significant improvements in overall quality of life, favoring social support interventions compared with control conditions over follow-up periods ranging from 4 to 12 weeks. Improvements were most consistently observed in emotional and social domains, whereas effects on physical functioning were smaller or mixed. Considerable heterogeneity was noted across study designs, intervention types, quality-of-life instruments, and cultural settings.
Conclusions:
Social support interventions appear to improve QoL among post-mastectomy breast cancer patients, particularly in psychological and social domains. While these findings support the integration of psychosocial care into postoperative management, substantial heterogeneity and methodological limitations across studies warrant cautious interpretation. Larger, high-quality, and culturally diverse trials are needed to confirm these effects and identify the most effective models of support.