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Background Mindfulness-based interventions (MBIs) can improve the symptoms and psychological well-being of patients with breast cancer. However, standard MBIs are an 8-week program delivered face-to-face, which may be inconvenient for patients with cancer. Many attempts have been made to adapt MBIs to increase their accessibility for patients with cancer while maintaining their therapeutic components and efficacy. Objective This study aimed to investigate the effectiveness of a 4-week internet-delivered mindfulness-based cancer recovery (iMBCR) program in reducing symptom burden and enhancing the health-related quality of life (HRQoL) of patients with breast cancer. Methods A total of 103 postoperative patients with breast cancer (stages 0 to IV) were randomly assigned to an iMBCR group (4-week iMBCR; n=51, 49.5%) or a control group (usual care and 4-week program of health education information; n=52, 50.5%). The study outcomes included symptom burden and HRQoL, as measured by the MD Anderson Symptom Inventory and the Functional Assessment of Cancer Therapy-Breast scale. All data were collected at baseline (T0), after the intervention (T1), and at 1-month follow-up (T2). Data analysis followed the intention-to-treat principle. Linear mixed models were used to assess the effects over time of the iMBCR program. Results Participants in the iMBCR group had significantly larger decreases in symptom burden than those in the control group at T1 (mean difference –11.67, 95% CI –16.99 to –6.36), and the decreases were maintained at T2 (mean difference –11.83, 95% CI –18.19 to –5.46). The HRQoL score in the iMBCR group had significantly larger improvements than that in the control group at T1 and T2 (mean difference 6.66, 95% CI 3.43-9.90 and mean difference 11.94, 95% CI 7.56-16.32, respectively). Conclusions Our preliminary findings suggest that the iMBCR program effectively improved the symptom burden and HRQoL of patients with breast cancer, and the participants in the iMBCR group demonstrated good adherence and completion rates. These results indicate that the iMBCR intervention might be a promising way to reduce symptom burden and improve HRQoL of patients with cancer. Trial Registration Chinese Clinical Trial Registry ChiCTR2000038980; http://www.chictr.org.cn/showproj.aspx?proj=62659

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BACKGROUND Mindfulness-based interventions (MBIs) can improve breast cancer patients' symptoms and psychological well-being. However, traditional standard MBIs are an 8-week program delivered by face-to-face treatment, which may be inconvenient for cancer patients. Many attempts have been made to adapt MBIs to increase their accessibility for cancer patients while maintaining their therapeutic components and efficacy. OBJECTIVE This study aimed to investigate the effectiveness of an internet-delivered 4-week mindfulness-based cancer recovery (iMBCR) program in reducing symptom burden and enhancing the health-related quality of life (HRQoL) of breast cancer patients. METHODS A total of 103 stage 0 to Ⅳ postoperative breast cancer patients were randomly assigned to an iMBCR group (4-week internet-delivered MBCR; n = 51) or a control group (usual care and 4-week program of placebo information; n = 52). The study outcomes included symptom burden and HRQoL, as measured by the M.D. Anderson Symptom Inventory (MDASI) and the Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) Scale. All data were collected at baseline (T0), post-intervention (T1), and 1-month follow-up (T2). Data analysis followed the intention-to-treat principle. Linear mixed models were used to assess iMBCR effects over time. RESULTS Participants in the iMBCR group had significantly larger decreases in symptom burden than the control group at T1 (mean difference, -11.67; 95% confidence interval [CI], -16.99 to -6.36), and the decreases were maintained at T2 (mean difference, -11.83; 95% CI, -18.19 to -5.46). The HRQoL score in the iMBCR group had significantly larger improvements compared with the control group at T1 and T2 (mean difference, 6.66; 95% CI, 3.43 to 9.90 and 11.94; 7.56 to 16.32; respectively). CONCLUSIONS Our preliminary findings suggested that the iMBCR program effectively improved the symptom burden and HRQoL of breast cancer patients. We highly recommend that healthcare professionals incorporate this program when providing psychosocial care to breast cancer patients. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR2000038980; http://www.chictr.org.cn/showproj.aspx?proj=62659