The Effectiveness of aromatherapy and its supportive Interventions on anxiety and pain among breast cancer patients: A systematic review and meta-analysis

Introduction: Breast cancer treatments are often associated with pain and anxiety, which can hinder physical functioning and overall quality of life, even after treatment. Complementary therapies, such as aromatherapy, can be used to alleviate pain and reduce anxiety in breast cancer patients. This project aimed to synthesize current global evidence on the effectiveness of aromatherapy. Method: This systematic review followed the PRISMA 2020 guidelines, with a comprehensive, systematic search conducted in PubMed, CINAHL, Cochrane Library, and SCOPUS for randomized controlled trials (RCTS) published from 2015 to 2025. Eligible studies included adult women breast cancer surgery patients who received aromatherapy during various periods of breast cancer. Where possible, data from the included studies were pooled using meta-analysis. GRADE approach was used to assess certainty of findings. Results: The search yielded 84 studies. Out of these, six were included in this review. On average, aromatherapy reduces pain and anxiety scores by 0.79 (standard mean difference (SMD)=-0.79, 95% CI -1.42, -0.16) and 0.53 (SMD=-0.53, 95 CI=-0.90, -0.16) units, respectively, compared to control condition [Low-quality of evidence]. The combination of aromatherapy with music reduces pain and anxiety by 1.26 (SMD= -1.26, 95 CI=-1.65, -0.87) and 1.08 (SMD = -1.08, 95 % CI: -1.45, -0.70) units respectively compared to standard care [Low-quality of evidence]. Conclusion: There is a potential role for the use of aromatherapy and music therapy, to alleviate anxiety and pain, especially for non-preoperative anxiety and pain. Further research is needed to inform the integration of aromatherapy into the management of anxiety and pain.