New analysis of 27 randomized trials points to lower anxiety and depression and better quality of life with e‑health support — though “distress” didn’t budge overall.

A comprehensive review in Cancers pooled results from 27 randomized controlled trials involving 2,898 participantsand found that e‑health programs—ranging from mobile apps and web portals to telehealth check‑ins and virtual‑reality tools—reduced anxiety and depression and improved quality of life for people living with breast cancer. The authors did not see a clear overall effect on cancer‑related “distress,” a broader measure of emotional strain.  

What counts as “e‑health” in this study?

The trials tested a wide mix of tools: smartphone apps for coping skills or symptom tracking, web‑based education and cognitive‑behavioral therapy modules, telehealth coaching, one‑to‑one remote counseling, and even virtual‑reality sessions. Examples summarized in the paper’s evidence tables include mHealth psycho‑education that boosted self‑esteem and eased anxiety, telehealth programs that improved self‑management and mood, and app‑based CBT that reduced anxiety and improved health‑related quality of life.  

Key findings at a glance

• Anxiety: Across 19 trials, e‑health interventions were associated with meaningfully lower anxiety versus usual care. In subgroup analyses, mobile‑app programs showed the clearest signal for anxiety relief. (See the forest plot for anxiety in Figure 4.)  
• Depression: Overall, depression scores improved. Web‑based programs showed a small but statistically significant benefit, while app‑based results were more mixed.  
• Quality of life: Across 19 studies (1,706 participants), e‑health users reported better quality of life than controls; mobile‑based programs reached statistical significance. (Figure 6.)  
• Distress: No significant overall effect—but programs lasting 12 weeks or longer did reduce distress on average. (Figure 7.)  

Why it matters

E‑health support can meet people where they are—reducing travel, saving time, and extending help to those in remote areas—benefits the authors highlight as telehealth and digital care become more routine since the pandemic. They also note how emerging AI could further personalize support and monitor side effects in real time.  

Caveats

Not every tool worked the same way for every outcome, and the included studies varied widely. Only three trials met all criteria for low risk of bias, many did not blind participants or staff, and statistical heterogeneity was high—so results should be interpreted with appropriate caution. (Risk‑of‑bias summary and graph on page 9.)  Still, checks for small‑study effects did not suggest major publication bias for anxiety, depression, or quality‑of‑life outcomes.  

Bottom line for patients and clinicians

Thoughtfully designed e‑health programs—especially those delivered consistently over 12 weeks or more—can be a useful add‑on to standard breast cancer care to help ease anxiety and depression and support day‑to‑day well‑being. People interested in digital support should ask their oncology team about evidence‑based options offered or endorsed by their center.  

Source: Mitsis A, Filis P, Karanasiou G, et al. “Impact of e‑Health Interventions on Mental Health and Quality of Life in Breast Cancer Patients: A Systematic Review and Meta‑Analysis of Randomized Controlled Trials,” Cancers 2025.  

Editor’s note: This article is for information only and is not a substitute for professional medical advice.