Effectiveness of Nursing-Led Pain Management Interventions for Adults with Breast Cancer: A Systematic Review

This systematic review examined nursing-led interventions for managing pain in adults with breast cancer. Following PRISMA, 1,196 records were identified from databases; 1,136 were removed before screening (502 duplicates and 634 marked ineligible by automation tools), 60 records were screened, 55 reports were sought, 41 could not be retrieved, and 14 studies were included. Included studies were classified by population: none of the 14 was restricted to Stage IV breast cancer (Category 1); five involved advanced or metastatic cancer or breast cancer populations (Category 2); and nine came from broader cancer populations or were contextual (Category 3). Findings were synthesized narratively, and study-level sample sizes, comparators, and effect estimates are tabulated; appraisal ratings of the rated studies ranged from moderate to high. Pain education showed a small pooled reduction in pain compared with standard care in broader cancer samples (12 studies; pooled effect −0.36), and one trial in metastatic cancer reported lower pain severity after pain self-management education. In contrast, a meta-analysis of 41 nurse-led symptom-management trials found no clear pain benefit, and a PRO-SELF trial (n = 64) improved self-efficacy, quality of life, and mood without significant pain differences. Two included reports were descriptive conference abstracts and one was a trial protocol, so they provided no comparative pain data. The evidence therefore supports nursing-led education and self-management as promising but indirect strategies for Stage IV breast cancer pain; Stage IV-specific comparative trials are needed. Implementation depends on nurse training, institutional support, medication access, and culturally responsive care.