11056 Background: Gender inequalities contribute to burnout and have contributed to an ongoing exodus of women from academic oncology. Our aim was to explore the perceptions and experiences of oncology professionals regarding gender bias in the workplace with the hope of providing critical information to support equity initiatives. Methods: An anonymous, 22-question survey was sent via Survey Monkey to 1512 physicians with oncology-related specialties from National Cancer Institute (NCI) designated cancer centers whose emails were publicly available. Likert-scale questions (never-rarely-sometimes-often-very often) were analyzed with Kruskal-Wallis and Wilcoxon rank sum tests (percentages shown as frequency of having responded “sometimes-often-very often”). Chi-square test was used for categorical variables. Results: A total of 274 physicians completed the survey (response rate 18%): 152 (55.5%) self-identified as female (F); 112 (42%) as male (M); 7 (2.6%) as gender non-conforming or transgender; 3 (1.1%) chose not to answer. Most were White (59.9%), followed by Asian (20.4%), Middle Eastern (5.8 %), Multiracial (5.1%), Hispanic (3.6%), and Black (1.5%). The plurality (n = 103; 37.6%) were < 40 years old. Primary fields of practice included 118 (43.1%) in adult oncology, 45 (16.4%) in combined hematology/oncology, 44 (16.1%) in radiation oncology, 44 (16.1%) in adult hematology, and 23 (8.4%) in other specialties. Female gender was associated with experiencing gender bias more often than male gender in the following areas: clinical practice (80.9% F vs 20.6% M), research activities (73.0% F vs 15.2% M), having difficulty balancing work and non-work responsibilities (95.4% F vs 78.6% M), being held to higher standards compared to physicians of other genders (73.1% F vs 14.2% M), being mistaken as a non-physician (78.9% F vs 6.3% M), and being scrutinized by others while tending to childcare needs (48.8% F vs 23.2% M) (all p <.001). Female gender was associated with using techniques to navigate gender challenges more often than male gender, including wearing a white coat (55% F vs 7% M; p <.001), ensuring that “Doctor” is written on identification (33% F vs 3% M; p =.002), emphasizing a professional look (53% F vs 10% M; p =.003) and working harder to establish expertise in the field (72% F vs 18% M; p =.003). When asked about strategies to address workplace gender-related bias, 63% would like policies on gender-related discrimination, (66.4% F vs 65.2% M; p =.93), 62% would like policies that prioritize leadership representation (74.3% F vs 51.8% M; p <.001), and relatively few (37%) would prefer formal lectures/instruction for staff (38.2% F vs 37.5% M; p >.99). Conclusions: Self-identified female academic oncologists at NCI Cancer Centers reported facing gender-related challenges in daily practice at much higher rates than men. There is a clear need to identify root causes and create initiatives to promote gender equity in the field of oncology.

Background: The treatment of Human Epidermal Growth Factor -2 (HER2) positive breast cancer has advanced since Trastuzumab and subsequently Pertuzumab were introduced and approved as antibody-targeted therapy. With the incorporation of anti-HER2 therapy, cardiotoxicity poses a significant risk and is a well know side effect. This toxicity can increase with concomitant use of Anthracyclines. Left Ventricular Global Longitudinal Strain is assessed using speckle tracking analysis on 2D echocardiogram and a relative reduction in LV global longitudinal strain (GLS) of 10-15% from baseline appears to have specificity to predict downstream reduction in Left Ventricular Ejection Fraction (LVEF). There is growing use for identification of GLS changes in these patients and its incorporation into medical decision making that impacts oncological and cardiac care. Methods: We conducted an analysis of 200 patients receiving anti-HER2 therapy at Henry Ford Cancer institute from Jan 1, 2016 to June 1, 2022 to determine if there was a 10-15% reduction in GLS detected prior to a decrease in ejection fraction and if and how these detections resulted in the implementation of cardio protective measures and downstream effects on cancer therapy. Results: There were 198 patients with GLS and LVEF data. 175 patients (88.3%) completed one year of cancer therapy 107/198 patients (54%) had no change in GLS or LVEF. 91/198 patients (45%) had changes in GLS and or LVEF. 41/91 (45%) patients with LVEF decline did not have cardioprotective intervention implemented. Despite this, 34 (83%) of these patients completed cancer treatment. 50/91 (55%) patients did have cardioprotective interventions with 40 (78%) patients from this subgroup completing cancer treatment. 81% of patients with EF decline were able to complete treatment. 50% of patients with EF decline had EF recovery within 6 months of completion of cancer therapy. The odds of LVEF decline were 9.8 times higher for those with GLS decline (OR=9.0, p&lt; 0.001). Patients with LVEF decline were more likely to have cardio preventive intervention (OR=18.8, p&lt; 0.001). Multivariate analysis did not find an association between cardiac risk factors such as hypertension, diabetes mellitus, smoking, obesity and hyperlipidemia with GLS decline. There was no disparity by race. Conclusion: Our study revealed that early changes in GLS and LVEF did not impact the completion of cancer treatment irrespective of implementation of cardioprotective measures. Citation Format: Hussna E. Abunafeesa, Cortney Mckay, Pin Li, Madhulata Reddy, Vrushali Dabak. Changes in Left Ventricular Global Longitudinal Strain in breast cancer patients receiving anti-HER2 and/or Adriamycin therapy and outcomes with early implementation of cardio-protective measures [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-07-35.