Luxembourg Stresses Importance of Early Breast Cancer Detection

Recent statistics on the causes of death in Luxembourg from 2021 reveal that tumours were the primary cause of mortality in the population. Among these, breast cancer stood out as the most prevalent form among women aged 50 to 70. On a global scale, the World Health Organization (WHO) reported that in 2023, nearly one in twelve women worldwide will develop breast cancer in their lifetime. Breast cancer constitutes a leading cause of female mortality.

Despite these "alarming" statistics, there has been significant progress in breast cancer treatment over recent decades, the ministry noted. According to WHO, in developed countries, breast cancer mortality rates, adjusted for age, have decreased by 40% between the 1980s and 2020. This notable improvement is attributed to early breast cancer detection followed by effective treatment involving a combination of surgery, radiotherapy and pharmaceutical interventions.

"Regular screening remains essential to better combat this disease, and it is vital to raise awareness among individuals at risk," emphasised Paulette Lenert, Luxembourg’s Minister of Health.

In this regard, the ministry is encouraging women aged 50 to 70 to participate in Luxembourg's organised breast cancer screening programme, known as the "mammography programme". This initiative targets women residing in Luxembourg and covered by the country's social security system (CNS). Within this age bracket, eligible women receive invitations every 23 months to undergo a mammogram at approved screening centres located in five hospitals across the Grand Duchy.

Between 1992 and 2022, the programme facilitated mammography screenings for 430,500 women aged 50 to 70, leading to the detection of breast cancer in 2,900 of them.

On average in Luxembourg, for every 1,000 mammograms conducted through the programme, 40 yield abnormal results. Among these, further examinations are conducted, and seven individuals are diagnosed with breast cancer.

Furthermore, the programme employs a rigorous approach to interpreting mammogram images, including a principle of double or even triple reading. Mammograms are initially assessed by an accredited radiologist at the screening centre and subsequently reviewed by a second radiologist at the Health Directorate. In cases where interpretations diverge, a third assessment is conducted during a discussion between one of the initial readers and one of the second readers.

This double reading process proves instrumental in detecting potential breast cancer cases that might have been missed otherwise. More than 25% of cancers are discovered thanks to this meticulous approach, the ministry stressed.

Additionally, a joint study conducted between the National Cancer Registry (Registre National du Cancer - RNC) and Luxembourg's breast cancer screening programme, spanning from 2013 to 2018, aimed to evaluate the effectiveness of breast cancer screening for women aged 50 to 70. The results revealed that cancers detected through the screening programme were less invasive, smaller in size, involved fewer lymph nodes and were diagnosed at a less advanced stage compared to cancers detected outside the programme.

In conclusion, Luxembourg's breast cancer screening programme achieved its objectives of early detection and improved prognosis. This study provided insights and methodology for assessing breast cancer screening programmes, utilising high-resolution data from population-based cancer registries.

Throughout Pink October, the Ministry of Health is participating in various awareness-raising activities across the country:

• awareness and information days in collaboration with the Cancer Foundation, Think Pink Lux and Europa Donna associations will be organised at various hospitals throughout October;
• Minister Lenert was present at the Broschtskriibslaaf (run for breast cancer) event, organised by Europa Donna, on Saturday 7 October in Hesperange Park, where she initiated the race;
• Think Pink is hosting the Race for the Cure in Echternach on Sunday 15 October 2023, and Luxembourg’s Ministry of Health will offer support during the race;
• a digital campaign featuring a video explaining cancer symptoms and the importance of screening, as well as a radio spot, will be launched on various platforms.

Efforts to optimise screening examinations outside the preventive programme have also yielded results, according to the ministry. Collaboration between the Health Observatory, the Luxembourg Institute of Health (LIH) and the federation of Luxembourg hospitals (Fédération des hôpitaux luxembourgeois - FHL) has led to a gradual improvement in waiting times, the ministry noted. Urgent examinations are now expedited and consultations between hospital stakeholders and physicians, supported by the Health Directorate, enable prompt examination appointments based on medical indications. Expanding operating hours and renewing the mammography equipment across hospital centres in the coming weeks and months will further enhance care and accessibility.