Table 1.
Characteristics of the Included Studies.
| Author/year/country | No. of acupuncture group/control group | Mean age of acupuncture group (years) | Mean age of control group | Status of cancer (years) | Current treatment | Hormone therapy | Duration | Outcome measures/results |
|---|---|---|---|---|---|---|---|---|
| Bao et al26/2013/USA | 23/24 | 61 (44-82) | 61 (45-85) | 0-III | Hormone replacement therapy | Letrozole and/or anastrozole, and/or exemestane ≥1 month | 8 weeks | Significant improvements in physical well-being (HAQ-DI; P < .03) and pain (VAS), significant reduction of IL-17 (P < .00), no significant modulation in proinflammatory cytokine (P > .05) |
| Crew et al27/2007/USA | 9/9 | 47 ± 1.1 | 43 ± 1.5 | II-III | Medicated with tamoxifen, postoperative radiation and chemotherapy | Letrozole and/or anastrozole, and/or exemestane, 6 months | 6 weeks | Significant improvements in anxiety (HADS-A; P < .00), depression (HADS-D; PSS; P < .00) |
| Crew et al28/2010/USA | 20/18 | 58 (44-77) | 57 (37-77) | I-III | Medicated with tamoxifen, chemotherapy and radiotherapy | Letrozole and/or anastrozole, and/or exemestane, 6 months | 6 weeks | Significant improvement in pain and physical well-being (WOMAC; BPI; P < .01), quality of life (FACT-B; BPI; P < .01) |
| Deng et al16/2007/USA | 42/30 | 53.5 | 54 | Unclear | Medicated with tamoxifen, postoperative radiation and chemotherapy | Tamoxifen and/or aromatase inhibitors, within 3 weeks | 4 weeks | No significant improvement in hot flashes (P > .05) |
| Nedstrand et al33/2005/Sweden | 19/19 | 53 | Unclear | Unclear | Medicated with tamoxifen, postoperative radiation, chemotherapy, and radiotherapy | Tamoxifen treatments mentioned, no details | 6 months | Significant reduction in hot flashes (P < .00), KI (P < .00) |
| Frisk et al34/2008/Sweden | 36/36 | 56.5 | 53.4 | I-III | Medicated with tamoxifen, postoperative radiation, and chemotherapy | >2 years sequential estrogen/progestagen combination, >2 years after menopause, given combined estrogen/progestagen | 6 months | Significant reduction in hot flashes (P < .00), KI (P < .05) |
| Hervik and Mjaland35/2009/Norway | 30/29 | 53.6 ± 6.4 | 52.3 ± 6.9 | Unclear | Postoperative radiation and chemotherapy | Tamoxifen for at least 3 months, mentioned, no details | 6 weeks | Significant reduction in hot flashes (P < .00), KI (P < .00) |
| Hervik and Mjaland36/2014/Norway | 43/45 | 52.5 | 50.2 | Unclear | Postoperative, medicated with tamoxifen | Tamoxifen for 3 months | 10 weeks | Significant reduction in KI (P < .10) |
| Hershman et al29/2018/USA | 110/57 | 60.8 | 60.6 | I-III | Chemotherapy, hormone therapy | Anastrozole, letrozole, exemestane | 6 weeks | No significant improvement in pain (BPI-WP; P > .05), physical well-being, and endocrine symptoms (WOMAC; FACT-ES; P > .05) |
| Johnston et al37/2011/USA | 5/7 | 55 ± 6.40 | 53 ± 7.2 | Unclear | Medicated with hormone replacement therapy, postoperative radiation and chemotherapy | Hormone replacement therapy mentioned, no details | 8 weeks | Significant improvement in fatigue (BFI; P > .05) and cognitive dysfunction (FACT-B; P > .05) |
| Lesi et al38/2016/Italy | 105/85 | 49 (31-65) | 50 (27-63) | Unclear | Postoperative chemotherapy | Hormone replacement therapy mentioned, no details | Significant improvements in sleep disturbances (PSQI; P < .00), hot flashes (GCS; P < .00) | |
| Liljegren et al30/2012/Sweden | 38/36 | 58 ± 6.8 | 58 ± 9.3 | I | Medicated with tamoxifen, and chemotherapy | Tamoxifen treatments mentioned, at least 2 months | 6 weeks | Significant reduction in hot flashes (P < .00), significant improvement in physical well-being (WOMAC; P < .01) |
| Mao et al31/2014/USA | 19/21 | 57.5 ± 10.1 | 60.9 ± 6.5 | I-III | Postoperative, medicated with tamoxifen, and chemotherapy | Anastrozole, letrozole, exemestane | 12 weeks | Significant improvements in pain (BPI; P < .00), stiffness (WOMAC; P < .00), and no significant improvement in physical well-being (PPT; P > .05) |
| Mao et al19/2014/USA | 19/21 | 57.5 ± 10.1 | 60.9 ± 6.5 | I-III | Hormone therapy | Anastrozole, letrozole, exemestane | 12 weeks | Significant improvements in fatigue (BFI; P < .00), anxiety (HADS; P < .044), depression (HADS; P < .01), sleep quality (PSQI; P < .05) |
| Mao et al39/2015/USA | 30/32 | 52.9 ± 8.6 | 52 ± 8.9 | I-III | Hormone replacement therapy | Tamoxifen, aromatase inhibitor mentioned, no details | 8 weeks | Significant reduction in hot flash (HFCS; P < .00) |
| Molassiotis et al17/2013/UK | 56/49 | 46 | 53 | I-IIIa | Medicated with tamoxifen, postoperative radiation and chemotherapy | Hormone treatments mentioned, no details | 10 weeks | No significant improvement in fatigue (MFI; P > .05), emotional well-being (HADS; P > .05), and quality of life (FACT-B; P > .05) |
| Nedstrand et al32/2006/Sweden | 17/14 | 30-64 (53) | Unclear | Unclear | Postoperative radiation and chemotherapy | Tamoxifen treatments mentioned, at least 12 weeks | 6 months | Significant reduction in hot flashes (P < .00), KI (P < .00), pain (VAS; P < .00), psychological well-being (SCL; P < .00), mood well-being (MS; P < .00) |
| Smith et al18/2013/Australia | 10/10 | 55 ± 8.8 | 53 ± 12.5 | Unclear | Surgical treatment | Hormone treatments mentioned, no details | 6 weeks | No significant reduction in fatigue (BPI-SF; P > .05), significant improvement on quality of life (MYCaW; P = .00) |
| Garland et al40/2017/Canada | 30/28 | 52.9 ± 8.6 | 50.4 ± 8.4 | 0-III | Postoperative chemotherapy | Tamoxifen, normatase inhibitors | 8 weeks | Significant improvement in sleep disturbances (PSQI; P < .00), hot flashes (HFCS; P < .00) |
| Yao et al41/2016/Korea | 15/15 | 56.2 ± 5.82 | 55.8 ± 5.02 | I-III | Chemotherapy, radiation, and therapy | Not mentioned | 6 weeks | Significant improvement in lymphedema (P < .00), quality of life (QLQ-30; P < .05) |
Abbreviations: HAQ–DI, Health Assessment Questionnaire Disability Index; VAS, Visual Analogue Scale; IL 17, interleukin 17; HADS–A, Hospital Anxiety and Depression Scale–Anxiety; HADS–D, Hospital Anxiety and Depression Scale–Depression; PSS, Perceived Stress Scale; WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index; BPI, Brief Pain Inventory; FACT–B, Functional Assessment of Cancer Therapy–breast Cancer; KI, Kupperman Index; FACT–ES, Functional Assessment of Cancer Therapy–endocrine Symptoms; PSQI, Pittsburgh Sleep Quality Index; GCS, Greene Climacteric Scale; PPT, Physical Performance Test; BFI, Brief Fatigue Inventory; HFCS, high fructose corn syrup; MFI, Multidimensional Fatigue Inventory; SCL, Symptom Checklist; MS, Mood Scale; BPI–SF, Brief Pain Inventory–Short Form; MYCaW, Measure Yourself Concerns and Wellbeing questionnaire.