Barriers and facilitators to timely care among women with abnormal mammograms from low-income or uninsured racial and ethnic minority groups.

151 Background: Despite advances in breast cancer treatment, disparities in timely access to diagnostic evaluation and treatment persist. Racial and ethnic minority patients and those who are un or under-insured remain disproportionately at risk. We sought to characterize perceived barriers and facilitators to timely diagnosis based on retrospective experiences following abnormal breast imaging. Methods: From 2017-2023, female patients aged 18–64 with BIRADS-4 or 5 screening or diagnostic mammograms were recruited if they met eligibility criteria of being uninsured, Medicaid-covered, or identified as members of racial or ethnic minority groups. Participants completed a 30-item questionnaire based on validated measures assessing perceived barriers to timely diagnosis and care. The survey included items on sociodemographic factors, screening behaviors, logistical and financial barriers, health communication and language challenges, trust in providers, and care coordination. Descriptive analyses were performed. Results: Among 26 respondents, patient-reported time to diagnosis following an abnormal mammogram varied (Table 1). Reported barriers included anxiety or fear (11, 42.3%), difficulty understanding medical information (10, 38.5%), transportation barriers (9, 34.6%), challenges coordinating care around work or childcare (9, 34.6%), and financial concerns (7, 26.9%). When asked about trusting cancer-related information from doctors, 6 (23.1%) responded “sometimes,” while the rest responded “yes.” Conclusions: In this diverse, predominantly low-income population, opportunities remain to improve timely breast cancer diagnosis after abnormal imaging. Patient-reported barriers included emotional distress as well as transportation, financial, communication, and work or childcare-related challenges. These findings support the need for multi-level interventions—such as patient navigation, culturally and linguistically appropriate education, and logistical support—to ensure timely follow-up and reduce disparities in breast cancer diagnosis and outcomes. Participant characteristics and reported barriers to timely diagnosis following abnormal mammograms. Characteristic n (%) Race/Ethnicity White 16 (61.5%), Black or African American 6 (23.1%), Hispanic; 8 (30.7%) Education High school or less 16 (61.5%) Household income < $50,000 19 (73.1%) Insurance Medicaid 16 (61.5%), Medicare 7 (26.9%), Private Insurance 3 (11.5%), Uninsured 2 (7.7%) Detection method Routine imaging 9 (34.6%), Self-detected mass 17 (65.4%) Time to biopsy ≤1 week 13 (50.0%), 1–2 weeks 9 (34.6%), 3–4 weeks 1 (3.8%), >4 weeks 3 (11.5%) Top barriers Fear/anxiety 11 (42.3%), Difficulty understanding 10 (38.5%), Transportation 9 (34.6%), Work/childcare 9 (34.6%), Financial 7 (26.9%) Trust in providers Yes 20 (76.9%), Sometimes 6 (23.1%)