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Reducing the bUrden of Breast cancer in Young women (RUBY) Study


The RUBY Study is a pan-Canadian collaborative comprised of a national network of 62 researchers and clinicians at 44 institutions and clinics across Canada, with the common goal of studying breast cancer in young women. Currently under the direction of Dr. Steven Narod (Principal-Investigator, Women’s College Hospital) and Dr. May Lynn Quan (Co-Principal Investigator, University of Calgary), the overall aim of this program is to establish a population-based cohort of 1,200 women newly-diagnosed with breast cancer aged 40 and under. Funded by a joint funding initiative through the Canadian Breast Cancer Foundation (CBCF) and the Canadian Institutes of Health Research (CIHR), this study cohort will support four synergistic sub-projects in order to enable the research team to comprehensively and holistically address major concerns for young women facing breast cancer. Read the press release.

Learn more about the research team.


Approximately 5.4% of breast cancer cases in Canada occur before the age of 40.  The relatively poor prognosis of young women with very early-onset breast cancer suggests that women diagnosed before the age of 40 may benefit from different treatments compared to older women. The differences in treatment may relate to supportive care and self-management, the influence of a several known genes, the impact of unhealthy lifestyle, making decisions about fertility preservation, the impact of various surgeries, treatment delay ramifications, and provision of optimal care through multi-disciplinary cancer conferences. Identifying whether these factors affect the outcomes of breast cancer in young women could ultimately impact treatment options and subsequent management of these patients.

The RUBY study is being conducted by a Canadian network of breast cancer researchers and surgeons, and it will include 1,200 young breast cancer patients diagnosed before the age of 40. The women will be enrolled over four years, during which our team will collect treatment information and details about lifestyle and fertility. The data and specimens will be made available to researchers across Canada to address many questions and to identify optimal treatments for this population and improve their chances of survival. In addition, a national web-based resource will be developed to assist women with overcoming the stress associated with a diagnosis of breast cancer.

We will use our study findings to advise provinces regarding genetic testing policies for breast cancer across Canada and to create a model framework for young women with breast cancer who wish to preserve fertility. The new knowledge we generate from this study will be used to help guide policy regarding the optimal treatment of breast cancer in young women and to improve prognosis and quality of life for these young women.

Learn more about the young breast cancer statistics here.


The four subprojects of RUBY are:

  1. The impact of modifiable lifestyle factors in breast cancer survival in young women (PI: Dr. Christine Friedenreich, University of Calgary).
  2. SPOKE & GYPSY: Studies to Encourage Early Fertility Preservation Referral and to Predict Effects of Treatment on Fertility of Young women with Breast Cancer (PI: Dr. Ellen Warner, Sunnybrook Health Sciences Centre).
  3. Expanded Genetic Testing in Women with Young Onset Breast Cancer (PI: Dr. Kelly Metcalfe, University of Toronto).
  4. Knowledge to Action: Improving local therapy for young women with breast cancer across Canada (PI: Dr. Nancy Baxer, St Michael’s Hospital).

Additionally, a new ancillary component, “The Online Supported Self-Management Tool for Young Women Newly Diagnosed with Breast Cancer,” was recently funded to provide women enrolled in the RUBY study with information and psychological support during their cancer trajectory (PI: Dr Tulin Cil, Women’s College Hospital; Co-PI: Dr. Joanne Stephen, University of Calgary).
Who can participate in RUBY?

Women newly diagnosed with breast cancer will be eligible to participate if they are

  1. diagnosed with invasive or ductal carcinoma in-situ disease;
  2. aged 18 – 40 at the time of diagnosis; and
  3. able to provide written informed consent and complete questionnaires in English or French.  

Please note all enrolment must be done through a RUBY participating surgeon. If you are interested in joining the RUBY study, please refer to the directory of participating recruitment sites here.

How to get more information?

If you have any questions regarding the study information or about our research in general, please feel free to contact ruby.study@wchospital.ca or 416-351-3765, or the project manager, Kristin MacLennan, at MacLennanK@smh.ca.

We are also working hard to develop a website for this study. Please stay tuned.





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