Abstract P2-01-11: Supportive Care Service Utilization Among Long Term Metastatic Breast Cancer Survivors

Abstract Background: Patients living with metastatic breast cancer (MBC) have unique psychosocial and medical needs, which often go unrecognized. Many MBC patients are now living years on chronic therapy. Understanding current referral patterns and utilization of supportive care services is a necessary step to improving patient access and aligning services with patient needs. We examined supportive care service utilization among long term MBC survivors to determine sociodemographic, psychosocial, and clinical predictors of utilization. Methods: 224 patients from the Ohio State University Stefanie Spielman Comprehensive Breast Center, who had been diagnosed with MBC for ≥1 year, were asked to complete a one-time, online survey to assess their quality of life, self-rated health, symptoms, supportive care needs, and reflections on their cancer diagnosis and treatment. Multivariate logistic regression was used to determine sociodemographic (age, race, education, income, rural/urban residency), psychosocial/quality of life (PROMIS physical component score, PROMIS mental component score, social support), and clinical factors (time since diagnosis, current treatment, metastasis site, fatigue, pain, and sleep) associated with utilization of supportive care services. Results: The mean age of the participants was 60.0 years old (±12.8 years) and the average time since stage IV diagnosis was 5.9 years (±4.9 years). Most participants were female (n=221), white (92%), non-Hispanic (98%), and about half had a total household income of < $75,000. Approximately 50% had a bachelor’s degree or higher, and 71% resided in urban areas and 29% in rural areas in the state. Most participants were currently receiving bone health support (47.8%), endocrine therapy (43.4%), or CDK4 inhibitor therapy (33.3%). About two-thirds of participants had metastases to the bone (66%) and 17% had metastases to the brain. Participants with the highest rate of referral to supportive services were those with metastases to the liver (49%), followed by bone (46.6%), brain (44.7%), lymph nodes (43.6%), and other sites (33.3%). Over 25% of participants used 3 or more services, however, the majority of participants reported not using any supportive care services (55.3%). The three most common referrals among the MBC survivors were for nutrition/dietitian services (19.3%), physical therapy (18.4%), and counseling services (18.0%). However, only 15% of participants actually reported receiving either nutrition/dietitian care (15.4%), physical therapy (14.9%), and/or counseling services (10.5%). Patients receiving services were more likely to be non-white (p=0.008), more highly educated (p=0.02), receiving chemotherapy (p=0.03), and with lower (worse) PROMIS physical and PROMIS mental scores (ps<0.01), higher levels of fatigue and pain (ps<0.02), and lower self-rated quality of life (p=0.005). In multivariate logistic regression models, those with better PROMIS mental health scores also had lower odds of using supportive care services (OR: 0.93, 95% CI: 0.86, 0.99, p=0.04). Conclusions: Survivors living with MBC in this study reported lower rates of referral and use of supportive care services than expected. Those who engaged with supportive care services often used multiple services compared to only one. Given this dichotomy, future studies are needed to determine if low rates of engagement are due to patient wishes or variability in screening and referral practices. More research is needed to determine processes that equitably and efficiently screen, refer, and engage eligible MBC patients with guideline-based supportive care services. Citation Format: Ashley Pariser Davenport, Chloe Hery, Kayla Williams, Juan Peng, Michelle J. Nauhgton. Supportive Care Service Utilization Among Long Term Metastatic Breast Cancer Survivors [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P2-01-11.