Bridging Gaps and Transforming CARE for Young Breast Cancer Survivors and those with Metastatic Disease - Young women with breast cancer are frequently diagnosed at an advanced stage, with aggressive tumor features, and suffer inferior survival outcomes compared to their older counterparts. Young breast cancer survivors (YBCS) require complex multi-modality therapy that is time-consuming, costly, and is associated with short and long term physical and psychosocial sequelae. Nearly 170,000 individuals are currently living with metastatic breast cancer (MBC) in the Unites States. Treatment advances have prolonged the lives of many patients, and the number of adults living with MBC is projected to grow by almost 100,000 in the next decade. The burden of a breast cancer diagnosis is not equitably experienced by women of different racial and ethnic backgrounds. Recognizing and addressing the unique needs of YBCS, those with MBC, and their families and care partners, through coordinated support and educational awareness are crucial throughout the trajectory of care. The catchment area at NewYork-Presbyterian (NYP), Weill Cornell Medicine (WCM), Sandra and Edward Meyer Cancer Center (MCC) is comprised of 3 hospitals in Manhattan, Queens, and Brooklyn. Of the patients treated across these hospitals, up to 24% are aged 45 years or younger, compared to 9% nationally. About 64% of the MCC patients identify as non-White, including 45% Asians in Queens, and 45% Blacks in Brooklyn. Dr. Vered Stearns and Dr. Tessa Cigler are joined by a cross disciplinary team of experts committed to expanding CARE (Coordination, Access, Resources, and Education) and tailoring services to our diverse sites with culturally tailored resources and interventions. We propose SMARTIE (Specific, Measurable, Achievable, Relevant, Time-Bound, Inclusive, and Equitable) activities to address 7 strategies: 1) Foster meaningful collaborative relationships with nongovernmental organizations that represent and serve priority populations; 2) Expand collaborative relationships with New York State Comprehensive Cancer Coalition to support the implementation of initiatives that support YBCS in the state and beyond; 3) Educate and inform survivors, caregivers, family members, and friends on treatment, symptom management, and provide care plans; 4) Identify and cultivate a sustainable action plan for the policy, systems, and environmental change agenda; 5) Provide innovative educational opportunities for health care providers; 6) Mobilize and educate community health workers and patient navigators to reach groups that have been economically and socially marginalized; 7) Provide equitable access to psychosocial support for YBCS, individuals with MBC, and caregivers to manage disease-related emotions, increase social support, improve symptom control. Through patient, provider, and community needs and resource assessments, specific activities, coupled with strong, longitudinal partnerships, and an engaged Stakeholder Advisory Board, we will execute a comprehensive program to ensure that YBCS, those with MBC, and their families/caregivers receive optimal individualized CARE at WCM-MCC. Our rigorous evaluation, logic model, and priority-setting actions will facilitate and lead to improved care delivery, treatment adherence, quality of life, and survival outcomes among racially, ethnically, and socio-economically diverse YBCS and those with MBC. Our collaborative initiatives will allow us to achieve our ultimate long-term goal of bridging gaps and transforming CARE for patients with breast cancer.
