Abstract Background: Breast cancer is a leading cause of cancer-related morbidity and mortality among women and is frequently associated with significant psychological distress, particularly around diagnosis, treatment, and survivorship transitions. Although up to 50% of patients experience clinically significant symptoms of anxiety or depression, mental health and emotional support services remain underutilized. This study aimed to evaluate the utilization of institutional psychosocial support services and identify factors associated with their use among breast cancer patients reporting moderate to severe psychological symptoms. Methods: We conducted a cross-sectional analysis using data from an electronic medical record-linked patient-reported outcomes registry at a single institution. Adult breast cancer patients who received care within the past year and reported moderate to severe psychological symptoms—defined as a score ≥4 on the Edmonton Symptom Assessment Scale (ESAS) for depression or anxiety—were included. Emotional support utilization was defined as having a documented referral to psychiatry, social work, or support groups. Patient demographic, clinical, and geographic factors were compared between users and non-users of psychosocial services using chi-square or two-proportion z-tests. Results: Among 340 eligible patients, only 118 (35.1%) utilized institutional emotional support services. Utilization was significantly higher among patients with greater symptom burden (ESAS 7-10: 63.3% vs. ESAS 4-6: 23.1%; p0.001) and those living within 30 minutes of the cancer center (43.5%) compared to those traveling 30-60 minutes (21.7%) or 60 minutes (12.5%) (p0.001). Trends toward higher utilization were observed among younger patients (50 years: 41.3%) and those identifying as white (40.8%), although these differences did not reach statistical significance. No significant associations were found for gender or cancer stage. Conclusion: Despite strong evidence supporting the benefits of psychosocial interventions in breast cancer care, institutional support services remain underutilized, especially among patients with lower symptom burden or longer travel times. Accessibility and perceived need appear to be key drivers of engagement. Addressing geographic and systemic barriers, increasing provider referrals, and assessing pre-existing support systems may improve equitable access to mental health care for breast cancer patients. Citation Format: A. Allibhai, A. Allibhai. Closer to Care, Closer to Help: Emotional Support Use in Breast Cancer Patients by Symptom Burden and Travel Time abstract. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-04-10.
Allibhai et al. (Tue,) studied this question.