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Purpose: Black women are more likely to develop early onset (age ≤50 years) breast cancer and have the lowest five year cause specific survival rate of any U.S. racial or ethnic group. The disparity in incidence and survival can be attributed partially to the higher rate of triple negative breast cancer (TNBC) in Blacks. Yet, little is known about health-related quality of life (HRQOL) among Black women with TNBC. Guided by the Contextual Model of HRQOL, the purpose of these analyses is to examine factors associated with HRQOL in patients with TNBC and non-TNBC. Methods: Black women with invasive breast cancer at age ≤50 years and diagnosed between 2009-2012 were recruited through the Florida State Cancer Registry as part of a population-based case-only study to investigate etiology and outcomes of early-onset invasive breast cancer (n=456). A subset of participants (n=355) consented to complete additional study questions assessing those sociodemographic, clinical, and psychosocial variables selected based on the Contextual Model. The Functional Assessment of Cancer Treatment-Breast (FACT-G) was used to assess HRQOL. Descriptive analyses included those participants confirmed to have either TN or non-TN disease (n=330); univariable and multivariable analyses included participants who met the aforementioned criteria and completed baseline HRQOL data (n=299). Results: Participants in the TNBC and non-TNBC group were similar (p>0.05) with respect to age (TNBC: 41.4 ±5.9 years; non-TNBC: 42.2 ±6.5) and time since diagnosis (TNBC: 18.5 ±7.0 months; non-TNBC: 19.8±10.1). TNBC participants had lower mean FACT-G total scores (71 ± 22.3) compared to non-TNBC (77 ± 21.6) participants (p Conclusions: The Contextual Model of HRQOL provides a useful framework for evaluating HRQOL in Black breast cancer patients; differences based on triple negative disease status suggest possible intervention targets to improve HRQOL in these women. Effective interventions should focus on reducing anxiety at the individual level, with additional consideration for depressed affect, cancer worry, and social support in the non-TNBC group. For patients with TNBC, interventions may include addressing fatalistic cognitions and collectivist attitudes that may adversely affect HRQOL. Citation Format: Susan T. Vadaparampil, Juliette Christie, Kristine Donovan, Jongphil Kim, Bianca Augusto, Cheryl Holt, Kimlin Ashing, Chanita Hughes Halbert, Tuya Pal. Health-related quality of life in black breast cancer patients with Triple Negative Breast Cancer (TNBC). [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B26.

Introduction: Although African American (AA) women are more likely to be diagnosed with early onset breast cancer (i.e., ≤ age 50) during their reproductive years, little is known about patient awareness of or provider discussion related to fertility concerns in this specific demographic group. In an effort to better understand how fertility concerns are addressed in the context of clinical care, this study seeks to document the prevalence of patient awareness and patientprovider discussion of infertility risk associated with cancer treatment in AA breast cancer patients. Method: As part of a larger study examining the role of genetic factors in AA women with early onset breast cancer, data were collected using a cross-sectional survey. Demographic and clinical variables were compared using chisquare tests for equal proportions or exact tests between participants who: (a) did and did not indicate awareness about potential fertility loss, and (b) did and did not report discussion of potential fertility loss with their health care providers. Results: Approximately 46% of the women in our sample (N = 48) reported awareness and 56.3% reported provider discussion of the potential impact of cancer treatment on fertility. Bivariate analyses demonstrated that awareness was significantly higher in women who were diagnosed at age ≤ 45 (p < .05), were nulliparous (p < .01), and/or did not have tubal ligation (p < .001). Provider discussion was more often reported by patients who were diagnosed in stages 2–3 (p < .05) and/or had no children (p < .01). Nearly half of early onset AA breast cancer patients are unaware and/or report no provider discussion of the potential impact of cancer treatment on fertility. Study results underscore missed clinical opportunities to provide fertility information that may impact long-term quality of life in early onset AA breast cancer patients. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A52.

Background: Low-income and minority women bear a disproportionate burden of cervical cancer. Many women who develop cervical cancer are eligible for or are participants of Medicaid. Providing human papillomavirus (HPV) vaccination to girls in Medicaid may help reduce subsequent cervical disparities observed in low-income and minority women. Provider recommendation is a critical factor associated with HPV vaccination. Purpose: The primary aim of this study was to evaluate provider characteristics associated with HPV vaccination among 9–17 year old female Medicaid enrollees. Methods: A sample of 800 providers was randomly selected from the Florida Medicaid Master Provider File. The sampling frame was restricted to providers who had: a physical address in Florida, billed claims or an assigned panel that included 25 or more 9–17 year old girls in the past year, and a specialty of Pediatrics, Obstetrics and Gynecology, or Family Medicine that included internal medicine, general practice, or preventive medicine. Physicians were mailed a survey in October 2009 that evaluated key factors related to HPV vaccination, including: 1) demographic and practice characteristics, 2) HPV information and knowledge, 3) barriers to HPV vaccination, 4) vaccine practices, and 5) vaccine recommendation practices. To measure HPV vaccination, Medicaid claims data were used to calculate the proportion of eligible patients who received at least one dose of the vaccine from sampled providers within the study period. Provider factors (e.g., provider specialty) associated with HPV vaccination at the bivariate level were evaluated simultaneously in a multiple linear regression model with HPV vaccination as the outcome variable. Results: The response rate was 68.3% (n = 485). After excluding respondents who identified themselves as unlikely to be involved in vaccination (e.g., hospice, emergency care providers; n = 23) or reported a specialty other than what was requested or no specialty (n = 23), the current analysis included 439 providers. The prevalence of HPV vaccination ranged from 0% to 61.9% (mean = 19.9, SD = 14.4). About 33% of the variance in HPV vaccine administration was attributable to the independent variables, F(14, 382) = 13.2, p < .0001, adjusted R2 = 0.3. Provider factors significantly associated with HPV vaccination included provider specialty, private vs. other practice, daily patient load, VFC provider status, patient race, and referring out for HPV vaccination. Private vs. other practice (e.g., ambulatory care clinic of hospital or medical center, urgent care clinic, community health center) was the strongest predictor of HPV vaccination (beta = −0.3, p < .0001). Conclusions: HPV vaccination has the potential to reduce cervical cancer disparities among low-income and minority women. Despite the financial coverage of the HPV vaccine for Medicaid-eligible girls, the average vaccination rates are low. Results of the current study can be used to target health services interventions to those providers least likely to administer HPV vaccine to female Medicaid enrollees. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B106.