Prophylactic acupuncture treatment during chemotherapy with breast cancer: a randomized pragmatic trial with a retrospective nested qualitative study

  • Benno BrinkhausEmail author
  • Barbara Kirschbaum
  • Barbara Stöckigt
  • Sylvia Binting
  • Stephanie Roll
  • Martin Carstensen
  • Claudia M. Witt
Clinical trial



This study investigated the effect of additional prophylactic acupuncture during chemotherapy on quality of life and side effects compared to standard treatment alone in breast cancer patients.


In a pragmatic trial, newly diagnosed breast cancer patients were randomized to additional acupuncture treatments over 6 months or standard care alone (control group). The primary outcome was the disease-specific quality of life (FACT-B). Twenty qualitative semi-structured interviews were conducted with ten patients from each group regarding their subjective experiences.


A total of 150 women (mean age 51.0 (SD 10.0) years) were randomized. For the primary endpoint, FACT-B total score after 6 months, no statistically significant difference was found between groups (acupuncture: 103.5 (95%, CI 88.8 to 107.2); control (101.4 (− 97.5 to 105.4); difference 2.0 (− 3.4 to 7.5) p = 0.458)). Qualitative content analyses showed that patients in the acupuncture group described positive effects on psychological and physical well-being. For both patient groups, coping strategies were more important than reducing side effects.


Breast cancer patients receiving prophylactic acupuncture during chemotherapy did not show better quality of life in the questionnaires in contrast to the reported positive effects in the qualitative interviews. Coping strategies for cancer appear to be important.

Trial registration; NCT01727362. Prospectively registered 11 July 2012; The manuscript adheres to CONSORT guidelines.


Acupuncture Breast cancer Quality of life Complementary medicine Pragmatic trial Comparative effectiveness research 


Author contributions

All authors participated in developing the study design and protocol and in revising the manuscript. Specific tasks and responsibilities: study conventionalization and general trial coordination (CW, BB), statistical expertise and analysis (SR, SB), data management (SB), study intervention (BK), and overall medical responsibility (MC). All authors read and approved the final manuscript.


The study was kindly funded by a grant of the Dorit & Alexander Otto Foundation, Hamburg, Germany. The funder asked for a trial to explore the effectiveness of acupuncture in patients with breast cancer while receiving chemotherapy. The funder had no influence on the trial design, methodology, data analysis, or interpretation of the results.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethics approval

All procedures performed in the study were in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards and with the local ethics review board (Ethic Committee of Medical Association Hamburg, Reference Number PV4002; June 2012). Because guidelines for chemotherapy treatment regime changed during the study and because of the inclusion of nested qualitative study, amendments were submitted and were approved in February 2014 and June 2016, respectively.

Research involving animal rights

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Charité – Universitätsmedizin Berlin, corporatemember of Freie Universität Berlin, Humboldt-Universität zuBerlin, and Berlin Institute of Health, Institute for Social MedicineEpidemiology and Health EconomicsBerlinGermany
  2. 2.Jerusualem HospitalHamburgGermany
  3. 3.Institute for Complementary and Integrative MedicineUniversity Hospital Zurich and University of ZurichZurichSwitzerland

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