Highlights
- •The treatment for breast cancer can lead to treatment-induced menopausal symptoms which are often sudden and severe.
- •The Greene Climacteric Scale is a well-validated climacteric symptom measure for midlife women from the general population but its applicability in the breast cancer population is difficult to determine.
- •Multitrait analysis showed acceptable convergent validity but weak discriminant validity for anxiety, depression, and somatic symptoms.
- •The original Greene Climacteric Scale factor structure undertaken in women not diagnosed with breast cancer was not replicated in this sample.
- •Among women treated for breast cancer, the presence of multiple concurrent and severe menopausal symptoms with possible treatment-related causes underpins the need for a breast cancer-specific measure to enhance their identification and management.
Abstract
Objectives
This paper examines the utility of a common climacteric symptoms scale, the Greene
Climacteric Scale (GCS), in two groups of women with a history of breast cancer, those
who were at menopause before commencing breast cancer treatment, and those who were
not.
Study design
This pooled analysis of 297 women previously diagnosed with breast cancer, aged 28–74
years, was undertaken on baseline data from two structured lifestyle interventions:
the Women's Wellness After Cancer Program (WWACP) and the Younger Women's Wellness
After Cancer Program (YWWACP). Data were split into two data subsets (women who were
post-menopausal on commencement of breast cancer treatment and those who were either
pre- or peri‑menopausal). Multitrait/multi-item analysis was conducted to test scaling
assumptions for each group separately.
Results
GCS domain scores were positively skewed, with significant floor effects for vasomotor
symptoms and ceiling effects for sexual dysfunction. Multitrait analysis showed acceptable
convergent validity (77% of items correlated ≥ 0.40 with their hypothesized domains)
but weak discriminant validity for anxiety, depression, and somatic symptoms in both
groups. The exploratory factor analysis in women who were menopausal at the commencement
of breast cancer treatment and those who were not revealed distinct factor structures
that accounted for 60.2% and 62.7% of the total variance, respectively.
Conclusions
The original GCS factor structure was not replicated in this sample. Among women previously
treated for breast cancer, the presence of multiple concurrent and severe menopausal
symptoms with possible treatment-related causes underpins the need for a breast cancer-specific
measure to enhance their identification and management.
Trial IDs, Australian and New Zealand Clinical Trials Registry
WWACP, ACTRN12614000800628; YWWACP, ACTRN12614001087640
Keywords
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Article info
Publication history
Published online: February 14, 2022
Accepted:
February 11,
2022
Received in revised form:
February 6,
2022
Received:
February 25,
2021
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
