223 Background: The incidence of metastatic breast cancer (MBC) in women under 40 is increasing. Sexual health is a key element of quality of life (QOL) and is impacted by MBC. While those searching the Internet receive primarily anecdotal information, the state of the science around MBC and sexual health for young women appears to be limited. Methods: Four databases were searched for English language articles: PubMed, PsycINFO, Embase, and Sociological Abstracts.Search topics included sexual health, sexual activity, intimacy, gender identity, sexual orientation, body image, and/or intimate partner relationships among young women with MBC. Results: 598 studies were reviewed; 9 met selection criteria. Four studies were included on body image and sexual activity: 2 reported a correlation between young age and poor body image; in a third, no relationship was found for women 30-49; in the fourth, among patients with metastatic or localized disease, women < 45 placed greater importance on body image or changes in sex life than women > 65. Three studies examined sexual health and treatment: a review of hormonal therapies in young patients recommended that sexual side effects be considered; a qualitative study reported on the impact of mastectomy on feelings of femininity and body image; an observational study of patients with locally recurrent or MBC found younger age was associated with greater vaginal dryness and decreased sexual interest/activity. One qualitative study did not find patterns of difference in sexual health needs related to age-patients of all ages and relationship status desired more information. In a study of QOL and MBC, younger age was associated with less sex life satisfaction. Subjects across all studies were primarily white, and sexual activity studied was primarily heterosexual, vaginal sex. Conclusions: The scientific literature on sexual health among young women with MBC is exceedingly limited. Studies that do examine sexual health often exclude those with MBC, do not examine the impact of age, and are focused on heterosexual, white women. Understanding the impact of MBC on young women’s sexual health can inform future care practices for this growing population.