3089 - Health-Related Social Risks (HRSR) and Psychosocial Needs Among Patients with Breast Cancer Treated with Radiation

Purpose/Objective(s):

Patients with breast cancer often require complex multimodal care and unmet HRSR and psychosocial needs can decrease quality of life and cancer outcomes. Given burdens associated with care, understanding HRSR is key to ensuring patients have access to time/travel intensive treatments like radiation.

Materials/Methods:

Patients were recruited from Breastcancer.org for an anonymous online survey in English or Spanish between 7/2023-8/2023. US residents aged =18 diagnosed with breast cancer within 10 years were included. Survey assessed HRSR (i.e. food, housing, transportation insecurity) and psychosocial concerns. Treatment details were collected, and the cohort was limited to those receiving radiation. Univariate and multivariate analyses (MVA) assessed responses across sociodemographic and clinical variables.

Results:

997 met eligibility and 548 (55.0%) had radiation as part of their care plan and were included. Patients were median age 63 (range, 32-97) and 3.5 (1.4-10) years post diagnosis. They were mostly White race (91%) and non-Hispanic ethnicity (99%), 68% had a bachelor’s degree or higher, and 94% had non-metastatic disease.

Overall, 18% endorsed at least one HRSR (Table). Hispanic patients had more transportation insecurity (29% vs 3% in non-Hispanic, p=0.015) and this kept them from getting medical care (29% vs 3%, p=0.019). There were more Black patients with food (15% vs 6% White patients) and housing (15% vs 5%) insecurity, but the difference was not significant.

Almost half (42%) felt at least “sometimes” lonely or isolated, despite most (92%) seeing or talking to friends/family at least 1-2 days a week. Most (80%) felt very confident managing their medical conditions on a daily basis but half (56%) felt at least “somewhat” overwhelmed by their healthcare. There were no differences by race/ethnicity.

On MVA, those with less than a bachelor’s degree had higher odds of having at least one HRSR (OR=2.81, 95% CI 1.77-4.45, p<0.0001) and older patients had lower odds (0.74 per 10 years, 0.60-0.92, p=0.005). Those with metastatic disease had higher odds of feeling overwhelmed (2.86, 1.26-6.53, p=0.0123), but older patients (0.78 per 10 years, 0.67-0.92, 0.0027) and those further away from diagnosis (0.88 per year, 0.81-0.96, 0.0044) had lower odds.

Conclusion:

More than one in six radiation patients with breast cancer had a health-related social risk, with Hispanic patients at highest risk for transportation insecurity interfering with their care. Over half felt overwhelmed at times and loneliness was also common indicating psychosocial needs. Interventions to screen and address unmet needs may be key to improving outcomes for radiation patients.

Abstract 3089 - Table 1: HRSR in the past 3 months

	n (%)
Debts	52 (9%)
Medical needs	42 (8%)
Food	34 (6%)
Housing	32 (6%)
Heat/electricity	30 (5%)
Transportation	16 (3%)
Childcare	4 (1%)
Other	5 (1%)
None	452 (82%)