Abstract only Introduction: Cardiovascular disease (CVD) prevalence and cancer mortality are higher in non-Hispanic Blacks (NHB) relative to other racial subpopulations. Hypothesis: Among females with BC (≥18 years), there are racial differences in cardiac events (CEV) which can be explained by adverse social determinants of health (SDOH). Methods: Data were obtained from a Cleveland area integrated health care systems informatics platform. (2005-2019). Zip-code level demographic features were extracted using the SDOH Database from the Agency for Healthcare Research and Quality. The CEVs included were heart failure (HF), acute coronary syndrome (ACS), and ischemic stroke (IS). Multivariable Cox proportional hazards regression models were used to examine racial disparities in CEVs. Race-stratified (NHB and non-Hispanic Whites NHW) multivariable logistic regression was performed to assess the role of each SDOH in association with CEV. Results: This study included 9,022 females with breast cancer (BC) of which 18.8% were NHB, and 48.7% had a CEV. The racial differences in CEV and the role of zip-code level SDOH are presented in Table 1. These racial differences were not explained by the proportion of people unemployed in the zip code (p=0.42, race*unemployment % cross-product), proportional of people in the zip code with only a high school diploma (p=0.66, race*education % cross-product), and proportion of people in the zip code who use public transport (p=0.24, race * transport % cross-product). Conclusion: There are racial differences in the risk of ACS and IS after a BC diagnosis, but this does not seem to be explained by the 3 adverse zip-code level SDOH included in this study. Therefore, studies with individual-level SDOH and including other domains are necessary to better understand their relationship with CEVs.