Abstract PS5-12-09: Breast cancer patient attitudes and experiences of health care in the post-COVID era: Landscape of recovery and trust at an urban US cancer center

Abstract Background: The fall-out of COVID-19 on breast cancer care delivery is yet to be fully understood and measured from the vantage point of all stakeholders, particularly the most vulnerable. At a U.S. comprehensive cancer center serving a very diverse, urban, and low-income community that was at the epicenter of the pandemic, identifying the impact on health care trust among these breast cancer patients is an important step in developing a roadmap for full recovery and responsiveness in the backdrop of a changing health care model. Methods: This descriptive analysis of an IRB-approved psychosocial needs assessment study examines attitudes and experiences around COVID-19, cancer care delivery, and medical mistrust from March 2024 to June 2025 among an ethnically diverse and underserved breast cancer patient cohort. Patients (n=135) were referred to a psycho-oncology program by their providers based on interest in counseling or support services. Patients identified as Hispanic (56%) or Black (38%) and were a mean age of 57.15 (25-86 yrs), with a median time since diagnosis of one year. Results: A COVID-19 history assessment found that 52% of patients had a past diagnosis and 28% lost a loved one to the virus. Almost all (94%) received the COVID-19 vaccine for reasons of: protecting self (63%), family (56%), or community (45%), chronic health condition (31%), MD recommendation (41%), reducing worry (38%), and job requirement (39%). While 65% felt getting vaccinated was the right decision and 42% report they are likely to get boosters, 27% regret getting the vaccine and 19% felt it harmed them. Next, patients were queried about their impressions of their most recent health care visit (80% oncology-related) using the Health Service Utilization Scale. Positive to negative ratings were as follows: wait time (85% to 5%), treated respectfully (93% to 3%), clear provider explanations (90% to 4.5%), shared treatment decisions (89% to 4%), private discussion time with providers (95% to 2%), happy with provider (88% to 5%), and facility cleanliness (96% to 1%). Lastly, based on items from the Group-based Medical Mistrust Scale in which “people of my ethnic group” is the reference perspective, 26% of patients reported disagreement with the statement that they receive the same medical care as other groups with 20% endorsing that doctors don’t take their medical complaints seriously and 14% felt they should be suspicious of information from health care workers and modern medicine. Conclusions: This psychosocial assessment of underserved breast cancer patients in the immediate post-COVID period sheds light on a wide range of health care perceptions from high satisfaction with care to substantial levels of medical mistrust and decisional regret. The contrast in these held beliefs may hold an important guidepost in how both the patient and the cancer care system can mutually heal and rebuild its relationship, with dialogue around values, goals, and shared decision making at the center. Citation Format: A. Moadel-Robblee, C. Garrett, D. Makower. Breast cancer patient attitudes and experiences of health care in the post-COVID era: Landscape of recovery and trust at an urban US cancer center 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 PS5-12-09.