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Early-stage breast cancer menopausal symptom experience and management: exploring medical oncology clinic visit conversations through qualitative analysis

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Abstract

Purpose

Women being treated with chemotherapy for breast cancer experience menopausal symptoms that vary in presentation and impact on quality of life. The clinical visit before each chemotherapy cycle provides an important opportunity to allow patients to dialogue with their medical oncology healthcare providers about these symptoms and identify strategies for self-management. The objective of this study was to characterize patient and provider interactions regarding the menopausal symptom experience and management in the context of breast cancer treatment.

Methods

Thematic analysis was employed to analyze 61 transcripts from clinical encounters of women receiving chemotherapy treatment for breast cancer. Transcripts were chosen based on their inclusion of menopausal symptom discussion.

Results

Themes were separated into three distinct categories: patient, clinician, and dyadic themes. The overarching theme was goal discordance in the clinical visit, which was reflected in the following themes: unexpected and unprepared; distressed, disrupted and disturbed; clinical insensitivity; missed opportunity for management and empathy; and use of humor and colloquial language. Overall, women were unprepared for the menopausal symptom experience, and clinicians did not often provide management, interventions, or empathetic responses.

Conclusion

There is a need to develop more astute assessment and communication regarding menopausal symptoms during the clinical visit. Possible interventions include a more holistic assessment, algorithms to facilitate the clinician’s attention and response to menopausal symptoms, and treatment of symptoms.

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Data availability

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Funding

This study was funded by the National Institute on Minority Health and Health Disparities.

Author information

Authors and Affiliations

  1. Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA

    Sarah A. Limbacher, Susan R. Mazanec, Jennifer M. Frame & Sumin Park

  2. School of Nursing, The University of Pittsburgh, Pittsburg, PA, USA

    Mary C. Connolly & Margaret Q. Rosenzweig

Authors
  1. Sarah A. Limbacher
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  2. Susan R. Mazanec
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  3. Jennifer M. Frame
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  4. Mary C. Connolly
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  5. Sumin Park
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  6. Margaret Q. Rosenzweig
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by all authors. The first draft of the manuscript was written by Sarah Limbacher and Susan Mazanec, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sarah A. Limbacher.

Ethics declarations

Ethical approval

The University of Pittsburgh (IRB number 19050299) and University Hospitals Cleveland Medical Center (IRB number 02–18-60C) provided ethical approval on 8/18/2017 and 3/22/2018, respectively.

Consent to participate

Informed consent included audio recording of clinical visits with an option to participate only in the survey portion of the study. Consent was also obtained from accompanying family members and healthcare providers.

Competing interests

The authors declare no competing interests.

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Limbacher, S.A., Mazanec, S.R., Frame, J.M. et al. Early-stage breast cancer menopausal symptom experience and management: exploring medical oncology clinic visit conversations through qualitative analysis. Support Care Cancer 30, 9901–9907 (2022). https://doi.org/10.1007/s00520-022-07446-z

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  • DOI: https://doi.org/10.1007/s00520-022-07446-z

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