Abstract PS5-11-15: The intersection of social determinants of health and healthcare needs among breast cancer patients: A qualitative content analysis

Abstract Importance: Breast cancer is a significant public health issue in the United States, representing 32% of all cancer cases among women and accounting for 14% of cancer-related deaths. Disparities in outcomes exist, particularly among low-income populations, including higher rates of incidence, delayed diagnosis, and poorer outcomes. These disparities are also linked to socioeconomic factors like limited access to and understanding of health information (collectively known as health literacy). Individuals with low-income and lower health literacy are more likely to experience poorer cancer outcomes, including delayed diagnosis, reduced treatment adherence, and higher mortality rates. Objective: The purpose of this study was to explore the intersection of Social Determinants of Health (SDOH) and healthcare needs documented in the electronic health records (EHR) of women with breast cancer, highlighting factors such as economic stability, neighborhoods, education, food access, community context, and healthcare systems. Design/Setting: The Kaiser Family Foundation (KFF) framework categorizes SDOH and emphasizes their impact on breast cancer care. This study utilized a deductive qualitative content analysis approach to identify SDOH documented in EHR of female breast cancer patients treated at a mid-sized mid-western academic cancer center from 2017 to 2022. Participants: Records for patients with a breast cancer diagnosis who received treatment (anticancer medications or therapies, radiation, surgery), were alive, and had at least one social work note were included. Breast cancer patients 18 years of age or older were included. Male breast cancer patients were excluded as a possible confounder due to the small sample size. Patients who were deceased or in end-of-life/hospice were also excluded. We randomly selected 200 patients, intentionally oversampling racial/ethnic minority patients to ensure there was balanced representation and a diverse final sample. The sample distribution of N=200 was 65.5% White, 28.8% Black, 2.2% Asian, 0.3% Native American, Alaskan, Pacific Islander, 1.7% Hispanic, 0.7% Multiracial, and 0.8% Other. The majority of patients were of non-Hispanic ethnicity (97.8%). Most of the participants were older adults, with an average age of 65 years old. Marital status included 38% who were married, 23% who were single, and 17.5% who were widowed. Almost half never smoked (49%), nor drank (42.5%), or used illicit drugs (70.5%). Results: Findings demonstrate the interconnectedness of various SDOH and their cumulative effects on patient outcomes. Economic strain, lack of transportation, and inadequate social support emerged as critical themes influencing patient experiences. Additionally, mental health was identified as significant, underscoring the necessity for holistic approaches that address both medical and non-medical factors in breast cancer management. Conclusion/Relevance: This study emphasizes the importance of healthcare providers routinely assessing SDOH to identify at-risk patients and connect them with necessary resources. This is especially important for patients who struggle to understand health information, follow treatment plans, and actively participate in their care. By integrating SDOH evaluations into clinical practice, healthcare professionals can enhance treatment adherence, improve health outcomes, and reduce disparities in breast cancer care. Ultimately, addressing SDOH can lead to better patient experiences, improved quality of life, and more equitable healthcare delivery. Citation Format: A. A. Wells, D. Wu, W. Hsu, B. Lartey, V. Schwegmann, C. Morrison. The intersection of social determinants of health and healthcare needs among breast cancer patients: A qualitative content analysis 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 PS5-11-15.