Who We Are

Reducing the Burden of Breast Cancer in Young Women (or RUBY) is a pan-Canadian collaborative comprised 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 1,500 women newly-diagnosed with breast cancer aged 40 and under. 

Approximately 5.4 per cent of breast cancer cases in Canada occur before the age of 40. Women in this age group face unique challenges that are often overlooked, such as stress from career interruptions, early menopause or diagnosis at the time of pregnancy. Research shows that they also suffer poorer prognosis and outcomes, suggesting that Young Women with Breast Cancer (YWBC) may benefit from different treatments compared to older women. 
The differences in treatment may relate to supportive care and self-management, fertility preservation, the influence of several known genes, the impact of lifestyle and nutrition, the impact of various surgeries and the ramifications of treatment delay. 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 1,500 RUBY participants 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 to help identify optimal treatments for this population and improve their chances of survival. 
Our research findings will be used to inform genetic testing policies for young women with breast cancer, provide a model framework for fertility preservation and support treatment interventions for optimal outcomes. The new knowledge generated from RUBY will be used to help guide provincial policies regarding the optimal treatment of young-onset breast cancer and to improve prognosis and quality of life for these young women.
We are funded through a joint funding initiative from Canadian Cancer Society and Canadian Institutes of Health Research (CIHR).


RUBY has four synergistic sub-projects that will help provide a holistic understanding of early-onset breast cancer. 
  1. The impact of modifiable lifestyle factors in breast cancer survival in young women: Led by Dr. Christine Friedenreich
  2. SPOKE & GYPSY: Studies to Encourage Early Fertility Preservation Referral and to Predict Effects of Treatment on Fertility of Young women with Breast Cancer: Led by Dr. Ellen Warner
  3. Expanded Genetic Testing in Women with Young Onset Breast Cancer: Led by Dr. Kelly Metcalfe
  4. Knowledge to Action: Improving local therapy for young women with breast cancer across Canada: Led by Dr. Nancy Baxter