Abstract
<title>Abstract</title> <p>Objective Menopausal symptoms are common after breast cancer treatment and can impair quality of life. Cognitive behavioural therapy (CBT) is an evidence-based non-pharmacological intervention, but access within routine oncology care remains limited. This service evaluation examined the implementation, service delivery and outcomes of a supervised clinical nurse specialist (CNS)-led CBT programme for menopausal symptoms in breast cancer survivors. Methods An uncontrolled repeated-measures service evaluation was conducted across three regional NHS Health Boards between October 2023 and November 2025. The intervention was a six-session face-to-face group CBT programme based on manualised approaches, delivered by trained CNSs with support from a CBT practitioner/Health Psychologist. Outcomes were assessed at baseline, post-intervention and 12-week follow-up. Linear mixed-effects models examined change over time in menopausal symptom burden, quality of life, anxiety, depression and fear of cancer recurrence. Results Ten groups were delivered. Eighty-seven patients registered, 72 attended at least one session, and 59 met the completion criterion of attending four or more sessions. Outcome data were available for 43 participants. Menopausal symptom scores decreased from baseline to post-intervention and remained lower at follow-up. Anxiety, depressive symptoms and fear of cancer recurrence also decreased, while quality of life improved. No outcome showed deterioration between post-intervention and follow-up. Conclusions Supervised CNS-led CBT programmes for menopausal symptoms can be embedded within routine breast cancer services and delivered across NHS settings. Participation was associated with improvements in menopausal symptom burden and broader psychosocial outcomes. Controlled studies using formal implementation frameworks are needed to establish effectiveness, sustainability and scalability.</p>