PS2-13-12: The BRAVE Study: Exploring the pathways to a breast cancer diagnosis from the perspectives of young survivors in California

Abstract Background: Incidence of breast cancer is significantly increasing in young women. Unfortunately, young women often present with more aggressive, advanced stage tumors and have poorer prognoses relative to older women, making timely diagnosis imperative. However, studies have shown that young women often experience diagnostic delays when it comes to breast cancer. To date, no study has explored the underlying reasons for such delays in young women in the U.S., which could inform strategies for timely diagnosis. Methods: As part of the Breast Cancer in Young Women: Awareness, Views, Experiences (BRAVE) Study, we conducted two virtual semi-structured focus groups with a total of 16 women diagnosed with breast cancer under age 40 in California to better understand their pre-diagnostic experiences, including their awareness, attitudes, and behaviors leading up to their diagnoses. Each focus group was recorded, transcribed, coded, and analyzed using NVivo 15, and emergent themes were identified. A survey that included demographic, tumor, and risk factor-related questions was also administered. Results: Across the 16 focus group participants, the average age at time of survey was 39 years and the average age at diagnosis was 35 years. Three key themes emerged from the focus groups. First, participants consistently felt a need and a sense of urgency to self-advocate, with many describing the diagnostic process as burdensome and requiring persistent interactions with healthcare providers. Second, a recurring concern participants expressed was the perception that their initial symptoms were dismissed or minimized by providers, usually attributed to their young age. Third, participants identified obstetrics/gynecology (OB/GYN) providers as central healthcare figures during their reproductive years, suggesting their potential gatekeeping role when it comes to addressing young women's breast health. Conclusions: Timely diagnosis of breast cancer in young women likely stems from a combination of factors, including patients' persistence and ability to self-advocate as well as healthcare providers' receptiveness to take further diagnostic steps despite patient' risk profiles indicating otherwise (e.g., age), which may be especially important for OB/GYN providers who often serve as young women's primary point of contact for health concerns. It is necessary to also explore the perceptions of a young woman's pathway to a breast cancer diagnosis from the perspectives of healthcare providers to better understand the barriers and facilitators to a timely diagnosis in young women. Interviews with providers as well as additional focus groups with young breast cancer survivors are currently underway. Citation Format: A. W. Lee, M. Sami, P. Fisher, D. Aguilar-Cruz, T. Do, M. Vargas, A. La Flair, N. Wells. The BRAVE Study: Exploring the pathways to a breast cancer diagnosis from the perspectives of young survivors in California [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 PS2-13-12.