e19029 Background: California has the most immigrants of any state in the U.S., with approximately a quarter of the residents being foreign-born. The impact of migration on breast cancer incidences over time has not yet been characterized in the Northern Central Valley. This provides a unique opportunity to study the influence of migration, socioeconomic gradient, and racial identity on the incidence of breast cancer in San Joaquin County. Methods: This study was a retrospective, single-institution study that compared the socio-demographic variables and clinical characteristics of the patients who had a history of breast cancer in a teaching central valley hospital. We reviewed all charts with a breast cancer diagnosis from 2014-2019. We compared age, demographics, socioeconomic status comorbidities, pathology, treatment, and outcomes. Appropriate statistics have been used to analyze the data. Results: A retrospective chart review of all patients with a diagnosis of breast cancer from 2014-2019 at a central valley teaching hospital. 33.5% were white, 17.2% African American, 26.6% Hispanic, and 22.6% were Asian. Migrated Asian women are having three times increased incidence in central California compared to their peers in Asian. Additionally, those of lower socioeconomic status were more often affected (61.9% vs. 30.4% of middle-class status) in our population. Demographics and comorbidities were studied. Smoking was seen in 23.2% of patients, alcohol in 16.3%, hypertension in 43.6%, Diabetes in 18.9%, lung disease in 11.7%, and Kidney disease in 6.9%. 23.8% of the patients had a family history of cancer. Screening was only done in 41% of patients, and the distribution of race was as follows: white 10.6%, African American 7.7%, Hispanic 8.9%, Asian 8.9%. It was found that infiltrating ductal carcinoma was seen in 54.8% of patients, of which 16.1% were white, 10% African American, 15.5% Hispanic, and 13.2% were Asian. Triple-negative breast cancer was seen in 14.9% in our patient population. We further reviewed treatment methods, including chemotherapy, radiation, and surgery, as well as recurrence rates. Conclusions: We suggest that screening has to be more concentrated in all communities. The fact that the Asian population in the Central Valley shows higher rates of breast cancer could be due to epigenetic, western lifestyle, and environmental factors. Higher awareness and willingness as a subgroup may be contributing as well or there may be an actual increase; this requires further investigation, and we will present further subgroup analysis at presentation.