The effect of mindfulness-based cognitive therapy on sexual self-esteem in women with breast cancer after mastectomy: a randomized controlled trial.

PURPOSE: Mastectomy often leads to decreased sexual self-esteem in women with breast cancer. This study aimed to evaluate the effect of Mindfulness-Based Cognitive Therapy (MBCT) on sexual self-esteem in women after mastectomy. METHODS: This randomized controlled trial (February-May 2024, Golestan Hospital, Ahvaz, Iran) enrolled 45 women aged 30-49 years after mastectomy. They were randomly assigned to an MBCT group (n = 22, eight weekly sessions) or a control group (n = 23, usual care). Sexual self-esteem was measured using the SSEI‑W‑SF at baseline and post-intervention. Data were analyzed using t‑tests and ANCOVA. RESULTS: No baseline differences were found between groups. Post-intervention, after controlling for confounders, the MBCT group showed significantly higher scores in total sexual self-esteem and subscales (attractiveness, experience/skills, control, adaptation) compared to controls (p < 0.001, η2 = 0.786). Moral judgment improved within the MBCT group (p < 0.001), but no significant between-group difference was observed (p = 0.106). The mean sexual self-esteem score was significantly higher in the MBCT group (145.95 ± 8.15) than controls (124.34 ± 10.09; p < 0.001). ANCOVA confirmed the intervention effect. CONCLUSIONS: MBCT significantly improves sexual self-esteem and its components in women post-mastectomy. Integrating MBCT into survivorship care may address an overlooked aspect of breast cancer recovery. IMPLICATIONS FOR CANCER SURVIVORS: MBCT is an effective non-pharmacological intervention for improving sexual self-esteem in women after mastectomy, enhancing their quality of life. TRIAL REGISTRATION: IRCT20231128060209N1 (registered February 5, 2024).