PS5-10-27: Integrating Virtual Collaborative Care Behavioral Health in Breast Cancer Care: Improving Outcomes in Mental Health, Adherence, and Racial Equity

Abstract Background: Patients with breast cancer often experience depression, anxiety, and reduced quality of life during treatment, yet mental health support is rarely integrated into oncology care. While collaborative care models have demonstrated efficacy in primary care, their impact in oncology remains under-explored. This study evaluated the impact of Cerula Care, a virtual collaborative care program, on mental health and quality of life among patients with breast cancer. Methods: We conducted a retrospective analysis of 207 patients with breast cancer enrolled in a virtual behavioral health program (Cerula Care) integrated into their oncology care. Patients received coordinated care from a psychiatrist, behavioral health care manager, and behavioral health coach. Depression (PHQ-9), anxiety (GAD-7), and quality of life (FACT-G7) were assessed monthly. Changes in outcomes were analyzed using paired-sample t-tests and correlations. Results: Participants were predominantly female (99%), with a mean age of 55.7 years; 58% identified as White and 32.4% as Black/African American. Medicaid patients had statistically significant higher anxiety and depression at baseline (GAD-7 mean = 10.67 vs. 6.62, p = .005), (PHQ-9 mean = 10.62 vs. 7.63, p = .004), and lower directionally lower functioning (FACT-G7 mean = 11.67 vs. 17.30, p = .073) showing the importance of screening Medicaid members who face greater stressors. Statistically significant improvements across all patients were observed in depression scores by month five (-6.63 points, n=32, p<0.001, Cohen's d=3.77), and anxiety scores improved by month six (-4.61 points, n=31, p<0.001, Cohen's d=5.38). Quality of life scores demonstrated a positive trend over time. Notably, identifying as Black was significantly correlated with greater improvements in quality of life (r=0.49, p=0.01), while identifying as White was correlated with less improvement (r=-0.46, p=0.01). Among patients who completed initial surveys, 70% reported that the program helped them consistently make it to their oncology visit and 65% noted improved adherence to their non-chemotherapy medications. Conclusions: Cerula Care’s virtual collaborative care model was associated with meaningful improvements in depression, anxiety, oncology visit and treatment adherence, and quality of life among patients with breast cancer. The greater benefit observed in Black patients highlights the potential to help address racial disparities in supportive oncology care. These findings support broader adoption of collaborative care approaches as scalable, patient-centered, and equity-promoting solutions in cancer treatment settings. Future studies should explore long-term outcomes, cost-effectiveness, and implementation across diverse populations. Citation Format: N. Balanchivadze, K. N. Lavin, J. L. Yourell, L. Wolfe, T. P. Menon, M. A. Danso. Integrating Virtual Collaborative Care Behavioral Health in Breast Cancer Care: Improving Outcomes in Mental Health, Adherence, and Racial Equity [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 PS5-10-27.