Background Financial Toxicity Among Underserved Breast Cancer Survivors Background: Breast cancer is the most common cancer diagnosed in the United States, and 1 in 5 breast cancer survivors reported experiencing financial burden. Cancer survivors develop a financial burden due to the high cost of cancer treatment, co-payments, medications, traveling expenses, and the change in the quality of life. About 30% to 42% of cancer survivors reported employment status changes because of cancer and spent 20% of their annual income on medical care. The accumulation of these economic burdens that distresses cancer survivors is defined as Financial Toxicity. In low-income populations, about 14.8% to 78.8% of cancer survivors experienced Financial Toxicity. Aims: The purpose of this study is to explore the scope and extent of financial challenges and contributing factors to financial toxicity. Methods: We interviewed 25 breast cancer survivors, including Hispanic and non-Hispanic Whites recruited from the local non-profit cancer organization in rural Central California. Individual interviews were conducted either in English or Spanish by the trained staff members from the organizations. The interview lasted about 50 minutes to an hour. Each interview was recorded, transcribed, and translated from Spanish to English. Results: Data were analyzed using thematic analysis. Financial challenges include 1) food insecurity; 2) paying bills; and 3) difficulty to pay for medical costs. Factors contributing to financial toxicity include 1) employment disruption; 2) family’s illness; 3) out-of-pocket costs (e.g., co-pay); 4) travel costs. Discussion/Conclusion: The results suggest the main issues contributing to the financial hardship directly affecting breast cancer survivors. Healthcare providers need to implement screening for financial toxicity and refer/link the breast cancer survivor to appropriate resourses (e.g., financial navigation program). In addition, information about financial resources, services, and non-profit organizations need to be available in the oncology clinics.