583eP Reducing inequalities in metastatic breast cancer care: Addressing structural and systemic barriers to care

Background: Breast cancer is the leading cause of cancer deaths among women worldwide, with metastatic breast cancer (MBC) accounting for 90% of these deaths.While there is no cure for MBC in the vast majority of cases, treatment options enable many people to live long and fulfilling lives with the disease.However, health inequalities are experienced by many, and intensified in underserved populations.Current policies often fail to recognise or address the unique challenges faced by this patient population.In 2024, a group of multidisciplinary experts convened to develop a set of policy briefs that explore opportunities and provide actionable recommendations to make MBC care more equitable.Their recommendations built on recent works, including the Lancet Breast Cancer Commission's 'roadmap for change' and the World Health Organization Global Breast Cancer Initiative Implementation Framework.In this abstract we explore how reducing inequalities in MBC care requires policymakers and health system decision-makers to address structural and systemic barriers to care.Methods: This policy brief was informed by a review of grey and peer-reviewed literature, and draws insights from an expert and multidisciplinary Steering Committee as well as nine expert interviewees.Results: Supported by case studies and examples, the brief outlines key actions for policymakers and health system decision-makers to address structural and systemic barriers to equitable MBC care, including: integrating MBC into all cancer policies and ensuring that guidelines offer evidence-based recommendations investing in systematic data collection as part of high-quality research into MBC determining the economic cost of MBC and maximising the cost-efficiency of care ensuring a sufficient, skilled workforce for MBC care. Conclusions:A variety of factorsat an individual, local, system and structural leveldisproportionately affect certain population groups and influence disparities in access to quality care.To support people with MBC from underserved populations, patient-centred policies, systems, environments and practices are needed.