Breast cancer survivors commonly experience a symptom cluster of fatigue, sleep disturbance, and depression (FSDSC) that impairs recovery and quality of life. This phase III randomized controlled trial aimed to evaluate the effectiveness and safety of a self-administered acupressure intervention on the FSDSC among breast cancer survivors and to report within-trial costs associated with the intervention as presented in the source abstract.
Eligible participants were randomized into three groups: a true self-acupressure group, a sham self-acupressure group, and a usual care group. The source reports 36 participants were allocated to each arm at randomization. Ninety-three participants completed the study; the abstract does not provide the final per-arm completion counts beyond the overall number.
The trial compared a true self-acupressure protocol with a sham self-acupressure control and a usual care control. The abstract indicates self-acupressure was performed by participants themselves, but it does not provide the detailed acupoints, frequency, or duration of individual sessions in the abstract text.
Primary outcomes targeted the FSDSC at both the cluster level and individual symptom level. Individual symptom instruments were:
A cluster-level FSDSC score was calculated as the mean of three separate 0–10 numeric rating scale scores for fatigue, depression, and sleep disturbance. The secondary clinical outcome was quality of life (QoL) measured with the Functional Assessment of Cancer Therapy–Breast (FACT-B).
Assessments occurred at baseline (T0, week 0), immediately after the intervention period (T1, week 7), and after follow-up (T2, week 19). Safety outcomes and within-trial cost data were also reported in the abstract.
The abstract reports that group-by-time interactions were tested for clinical outcomes and QoL. Subsequent pairwise comparisons between groups at T1 and T2 were performed. Reported p-values indicate statistically significant differences where stated. The abstract does not detail the specific statistical models, handling of missing data, or adjustment methods.
Significant group-by-time interactions were observed for all clinical outcomes and QoL. Pairwise comparisons showed that the true self-acupressure group had significantly better FSDSC scores than both the sham self-acupressure and usual care groups at T1 and T2 (all p < 0.01). These results indicate an effect of true self-acupressure on the combined symptom cluster at the end of the intervention and at follow-up.
At the level of individual symptoms, the abstract reports:
PSQI (sleep): The true self-acupressure group had significantly better PSQI scores than both comparison groups at T1 and T2 (all p < 0.05).
HADS-D (depression): The true self-acupressure group had significantly better HADS-D scores than both comparison groups at T1 and T2 (all p < 0.05).
BFI (fatigue): The true self-acupressure group had significantly lower (better) BFI scores than the usual care group at both T1 and T2 (both p < 0.0001). Comparison between true and sham self-acupressure showed a statistically significant difference only at T2 (p = 0.0076), but not at T1 according to the abstract.
These findings suggest that the sleep and depressive symptom components responded early to the true self-acupressure intervention and that fatigue showed robust improvement relative to usual care, with a delayed separation from sham.
For the secondary outcome of QoL measured by FACT-B, the true self-acupressure group achieved significantly higher total FACT-B scores than the usual care group at both T1 and T2 (both p < 0.0001). The difference between true and sham self-acupressure was not statistically significant at T1 (p = 0.069) but reached statistical significance at T2 (p = 0.0002). This pattern parallels the symptom findings where some benefits became more pronounced at follow-up.
No adverse events were reported in the abstract. The abstract begins a sentence reporting that during the trial only one participant in each of the true self-acupressure and usual care groups reported healthca—however, this sentence is truncated in the source abstract and does not provide the completed statement or further healthcare use or cost details. Therefore, comprehensive within-trial cost data and the full healthcare-use sentence are not available from the provided abstract.
Interpretation: The trial as reported in the abstract found that a self-administered true acupressure intervention produced statistically significant improvements in the FSDSC and QoL compared with sham and usual care at both immediate post-intervention and at 12-week follow-up. The absence of reported adverse events supports an acceptable safety profile within the trial context.
Strengths reported in the abstract include randomized allocation and use of validated instruments for fatigue, sleep, depression, and QoL. Limitations apparent from the abstract include incomplete reporting of intervention specifics, missing detail on statistical methods, limited safety and cost detail due to truncation of the abstract sentence, and lack of per-group completion numbers in the abstract beyond the total who completed the study.
According to the published abstract, true self-acupressure improved the fatigue-sleep disturbance-depression symptom cluster and quality of life in breast cancer survivors compared with sham and usual care, with effects evident at the end of the intervention and sustained at week 19. No adverse events were reported. Detailed intervention parameters, full safety and healthcare-use reporting, and within-trial cost data were not fully provided in the abstract and would require consultation of the full article for comprehensive appraisal.