Breast cancer is the most prevalent cancer in women and annually accounts for 10% of new
malignancies worldwide. In mainland China, approximately 169,000 females are diagnosed with
breast cancer every year and constitute 12.25% of the breast cancer incidents worldwide.
Additionally, 30% of early breast cancer turns metastatic, which is often incurable.
Different from women with early breast cancer, women with metastatic breast cancer(MBC)must
receive lifelong treatment, experience higher levels of emotional/physical distress, and feel
frequent uncertainty about their health/possible death. They are also challenged to manage
distressing adverse effects induced by different adjuvant treatments and experience heavy
self-care demands during the transition period from being a patient to being a survivor.
Thus, specific interventions to help women with metastatic breast cancer to recover from this
traumatic event have been designed, and one of these is supportive-expressive group
therapy(SEGT).SEGT has been found to achieve improvement in anxiety, depression, quality of
life (QoL), family functioning, and satisfaction with treatment. However, the effect of SEGT
on survival is inconsistent. Initial studies examining SEGT have reported a mean survival
advantage of 18 months, however, these findings could not later be replicated.Yet, no study
has reported a survival disadvantage for those given SEGT. In addition, we found no published
articles on the application of SEGT among women with MBC in China. Owing to this dearth of
previous research, it is unclear whether this therapy would exhibit positive effects within
Chinese culture. Thus, we developed a "Be Resilient to Breast Cancer"(BRBC) program that is
culturally tailored for Chinese females with MBC. This program was adapted from SEGT and is
designed to increase resilience(defined as the capacity to bounce back after encountering a
traumatic event) and QoL, decrease emotional and physical distress(allostatic load), and
eventually prolong longevity. To better adapt to Chinese culture, we added education hosted
by professional staff (e.g., clinical psychologists, dietician, Chinese medicine
practitioner, etc.)in an effort to foster self-efficacy to combat symptoms (such as pain,
fatigue, intrusive thoughts, etc.) through knowledge and technics (such as breath control,
meditation, etc.),and to help patients gain a sense of control in their life. Second, trained
mentors, who were breast cancer survivors themselves, were added to the group discussion to
create non-hierarchical, reciprocal relationships through the sharing of experiences with
those facing similar challenges. These mentors also provided women with first-hand
information about treatment and offered suggestions to combat barriers to recovery.