Research

One of the main goals of PYNK is to not only give our young patients at Sunnybrook the best possible "whole person" care, but to improve the treatment of all young women with breast cancer through research. Women in the program are offered (entirely voluntary) participation in many different studies aimed to advance our knowledge about cancer prevention, screening, treatment and supportive care of young women with breast cancer.

Completed projects (partial list)

• Srikanthan A et al. Does a dedicated program for young breast cancer patients affect the likelihood of fertility preservation discussion and referral? The Breast, 27:22-26, 2016.
• Morarji K, McArdle O, Hui K, Gingras-Hill G, Ahmed S, Greenblatt EM, Warner E, Sridhar S, Ali AMF, Azad A, Hodgson DC. Ovarian function after chemotherapy in young breast cancer survivors. Current Oncology, 24(3):1-9, 201.7 June
• Warner E, et al. Effect of a knowledge translation intervention on breast surgeons’ oncofertility attitudes and practices. Annals of Surgical Oncology, 27:1645-52, 2020 May. 
• Ali A et al. The Impact of a Breast Cancer Diagnosis in Young Women on their Relationship with their Mothers. The Breast 23(1):50-5, 2014.
• Fergus K et al. Development and pilot testing of an online intervention to support young couples' coping and adjustment to breast cancer. Eur J Cancer Care (Engl). 23(4):481-92, 2014
• Lee GE et al. Ten year survival in women with primary stage IV breast cancer. Breast Cancer Research & Treatment, 160(1):145-52, 2016 Nov. This study showed a better outcome in young women with stage IV cancer than in older women
• Quan M, et al. The effect of surgery type on survival and recurrence in very young women with breast cancer. Journal of Surgical Oncology, 115(2):122-30, 2017 Feb. This study showed that type of breast surgery had no effect on the survival of young women 
• Esplen MJ,et al. Restoring Body Image after Cancer (ReBIC): Results of a Randomized Controlled Trial. Journal of Clinical Oncology, 36(8):749-56, 2018 March. 
• Azulay Chertok IR et al. Infant feeding among women with a history of breast cancer, Journal of Cancer Survivorship 14: 356-362, 2020 Jan. 
• Poorvu PD,et al. Prognostic impact of the 21-gene Recurrence Score assay among young women with node-negative and node-positive ER+/HER2- breast cancer. J Clin Oncol, 38(7):725-33, 2020 March. 

Ongoing projects

• Reducing the burden of breast cancer in young women (RUBY)
  This is a $6 million Canada-wide study (at over 30 centres) that has enrolled over 1200 patients aged 40 and younger since 2015. Extensive data from patient charts, patient questionnaires, blood and tumour samples is being collected from each patient. There are multiple research questions being studied now on these women and the data will be an invaluable resource for future research. Over 80 PYNK patients have enrolled in RUBY as of August 2020.

• Evaluation of clinical outcomes in women with pregnancy-associated breast cancer (PABC)
  Between the start of PYNK in 2008 and the start of RUBY in 2015, almost 300 PYNK patients were registered in a database with clinical data, blood and tumour samples collected as in RUBY (PYNK was actually the prototype for RUBY). The databased in updated regularly with the status of the patients. We are comparing outcomes and determinants of recurrence in women with pregnancy-associated breast cancer compared to age-matched women

• Pregnancy outcome and safety of interrupting therapy for women with endocrine responsive breast cancer (POSITIVE)
  This international study is following 500 women (including many PYNK patients) with hormone-sensitive breast cancer who interrupted their hormonal therapy in order to have a baby (and in many cases also breastfeed).

• Helping Ourselves Helping Others (The Young Women’s Breast Cancer Study) in collaboration with Harvard’s Dana Farber Cancer Institute
  This project is looking at multiple research questions by studying 1300 young women (including over 50 PYNK patients) enrolled between 2006 and 2016.

• Long-term neurodevelopment of children exposed to maternal chemotherapy and/or surgery for breast cancer during pregnancy in collaboration with SickKids Hospital

Clinical trials

Our breast site group always has multiple studies running that are attempting to find better systemic, radiation and/or surgical treatments for breast cancer. While most of these studies are not limited to young patients, our PYNK patients have full access to these trials, which often involve novel treatments not available outside of a study.