Abstract P4-01-08: PYNK at 20: From SABCS Inspiration to Multisite Clinical, Research, and Educational Program for Young Women with Breast Cancer
Bibliographic record
Abstract
Abstract Introduction: The last session of the 2004 San Antonio Breast Cancer Symposium focused on the unique biological, fertility, and psychosocial issues faced by women diagnosed with breast cancer at age 40 or younger (YWBC). Attendees EW and JW, for whom this was a startling eye-opener, returned to Sunnybrook Health Sciences Centre in Toronto determined to create an interdisciplinary program for YWBC. Their vision was to ensure these patients received: 1) State-of-the-art clinical care, 2) A continuum of support for themselves and their families, and 3) Educational resources. Additional priorities would be: 4) Clinical and translational research focused on YWBC, and 5) YWBC-focused education of health care professionals. Today’s PYNK program - its origins and operations (including challenges and successes) - are described in this presentation. Methods: From January 2005 through January 2008 the program infrastructure was built. Steps included: Review of the literature on unmet needs of and existing programs for YWBC; Monthly meetings of a multidisciplinary executive from medical, radiation, and surgical oncology, nursing, social work, psychology plus 2 young breast cancer survivors; Presentations to skeptical colleagues and to ”management” who liked the concept but could not offer financial support; Establishment of a seamless fertility preservation referral process; Fundraising to pay a part-time nurse for the 1st year; Creation of a prospective research database, serial patient questionnaires, and a mechanism for storing baseline blood; and Selection of a name for the program: PYNK. Results: Since the enrollment of the first patient in Feb. 2008, there have been 40 to 50 newly diagnosed patients per year who remain in the program until discharged from our centre. Within 2 years a full-time nurse navigator became necessary. Since Jan. 2023 the navigator role has been taken over by a Physician Assistant (SV). Program objectives: 1 & 2) The navigator, along with the social worker (BM), meets the patient +/- accompanying family shortly after the 1st visit post-diagnosis, helps facilitate referrals/appointments, provides intensive support through active treatment, and medical/psychosocial support as needed thereafter. The navigator and social worker also co-lead 2 monthly support groups, one for non-metastatic and one for metastatic patients. A child life specialist is available when necessary for home visits to children. 3) In addition to brochures, books, and educational events, an online multimedia virtual library focusing on YWBC issues is maintained. 4) Consenting patients were enrolled in the prospective clinical database including family history, lifestyle factors, and serial psychological measures until 2015 when PYNK became one of the biggest contributors to the pan-Canadian RUBY (Reducing the bUrden of Breast cancer in Young women) prospective cohort. We have also enabled our patients to join pivotal trials such as the Dana Farber’s Young Women’s Breast Cancer Study and the Breast International Group’s POSITIVE study (NCT02308085). 5) Trainees of all levels and health disciplines rotate through PYNK clinics. In addition, we host formal CME events. Conclusions/Discussion: Since 2008, PYNK has helped hundreds of YWBC and their families manage their complex medical and psychosocial issues. PYNK research has resulted in numerous presentations and publications. Trainees learn unique skills and perspectives about YWBC management. In 2023 PYNK expanded to 2 additional donor-funded sites in the Greater Toronto Area. PYNK has not only been a model for other YWBC programs internationally but has sparked the creation of special programs for young patients in other disease sites. The greatest strength of PYNK has been the continuous input of the YWBC themselves on its executive. Citation Format: Sandy Vuong, Katarzyna Jerzak, Brooke Macdonald, Yonina Juni, Alexandra Landsberg, Karen Fergus, Judith Weinroth, Ellen Warner. PYNK at 20: From SABCS Inspiration to Multisite Clinical, Research, and Educational Program for Young Women with Breast Cancer [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P4-01-08.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.006 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.222 | 0.044 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".