Abstract PS4-12-04: Late-stage breast cancer in young appalachian women: missed hereditary risk and persistent disparities in a community health setting

Abstract Background: The incidence of breast cancer among young women is on the rise. In rural regions, a combination of socioeconomic disadvantages, poor health literacy, and limited access to specialized care exacerbates diagnostic delays, even more so in patients with hereditary risk. This study investigates the stage of presentation, family history, genetic testing uptake, and social determinants of health among young women diagnosed with breast cancer in a community health setting in Appalachia. Methods: This retrospective cohort study included 1,359 patients diagnosed with breast cancer at Tennova North Knoxville Medical Center from 2020 to 2024. Patients were stratified by age, i.e. young patients ( 80% of cases. Profound disparities in genetic testing utilization, driven by socioeconomic status, rurality, and health literacy, likely contribute to missed opportunities for early detection. These findings underscore the urgent need for community-based hereditary risk screening programs, access to genetic counseling, and culturally competent education strategies within rural healthcare systems. Citation Format: J. Gill, N. Lopetegui-Lia. Late-stage breast cancer in young appalachian women: missed hereditary risk and persistent disparities in a community health setting [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 PS4-12-04.