Acupuncture and Related Therapies for Breast Cancer-Related Symptoms: An Evidence Map

BackgroundBreast cancer is the most frequent malignancy among women worldwide. Despite advances in medical treatment, many survivors experience distressing symptoms and therapy-related side effects that impair quality of life. Acupuncture-related therapies are increasingly employed as supportive care strategies, yet their evidence base remains fragmented.ObjectiveTo construct an evidence map of systematic reviews (SRs) and meta-analyses evaluating acupuncture and related therapies for breast cancer-related symptoms.MethodsSearches were performed in PubMed, Embase, and Cochrane Database of Systematic Reviews, China National Knowledge Infrastructure (CNKI), Wanfang, Research Information Service System (RISS), Oriental Medicine Advanced Search Integrated System (OASIS), and Korean Studies Information Services System (KISS) from inception to April 24, 2025. Eligible SRs included breast cancer populations, any acupuncture-related intervention, and reported outcomes relevant to symptom management or treatment side effects. Data extraction included bibliographic details, intervention type, outcomes, number of studies, sample size, effect direction, and methodological quality (AMSTAR-2). Evidence was synthesized descriptively and presented using heatmaps.ResultsA total of 47 SRs with meta-analysis were included, covering 11 distinct symptom domains and 6 categories of interventions. The most frequently studied outcomes were hot flashes (n=9), general supportive care during chemotherapy (n=9), lymphedema (n=7), general side effect management (n=6), and aromatase inhibitor-associated arthralgia (n=4). The most common interventions were acupuncture (n=17), acupuncture combination therapies (n=16), and acupoint injection (n=9). Across the included SRs, 20 reported positive effects, 23 were mixed, and 4 reported no clear evidence of benefit. Only 8 of 47 SRs achieved moderate confidence, and none were rated high, indicating widespread methodological limitations across the evidence base (29 low, 10 critically low).ConclusionAcupuncture and related therapies are widely studied as supportive care strategies for breast cancer-related symptoms with promising evidence. However, the majority of SRs are of low methodological quality. High-quality trials and rigorously conducted systematic reviews are needed to strengthen the evidence base, reduce redundancy, and guide integrative oncology practice.