Psychometric validation of the Stressors in Breast Cancer Scale in Greece: evidence for a five-factor structure

A breast cancer diagnosis causes significant psychological stress throughout the disease trajectory. While generic stress measures exist in Greek, validated cancer-specific stress assessment instruments are lacking. The Stressors in Breast Cancer Scale (SBCS) is a 24-item instrument assessing five stress domains: appearance/sexuality, health/daily life, interpersonal relationships, healthcare system and future worries. Given this gap in Southern European populations, this study evaluated the psychometric properties of a Greek translation of the SBCS. A cross-sectional design was employed with a sample of 216 Greek women diagnosed with breast cancer. The scale's internal structure was examined through Exploratory and Confirmatory Factor Analysis (EFA, CFA). Internal consistency was assessed using Cronbach’s alpha and McDonald’s omega coefficients. Convergent validity was assessed through correlations with perceived stress and anxiety; discriminant validity was evaluated via comparison of AVE square roots with inter-factor correlations. The original five-factor structure was supported, demonstrating acceptable model fit (CFI = .956, TLI = .951, RMSEA = .080, SRMR = .063). Internal consistency was high (α = .94). The SBCS- GR showed strong positive correlations with perceived stress and anxiety. These findings provide evidence supporting the structural validity and reliability of the SBCS- GR. The instrument may serve as a clinically relevant tool for identifying multidimensional stressors in breast cancer patients in Greece.