On October 1st, it is the kickoff of Pink October, breast cancer screening awareness month. While more than 60,000 breast cancers will be diagnosed in women in 2023, fewer than one in two eligible for these screenings have undergone a mammogram or clinical examination. Normandy is a particularly poor performer among French regions, with France itself lagging behind in this area in Europe. “Screening in France is insufficient compared to European objectives, explains Dr Ahmed Benyoucef, head of the radiotherapy and medical physics department at the Henri-Becquerel center in Rouen. In France, the objective is to screen 70% of women. It is a culture of prevention that will need to be developed in the years to come, particularly with regard to children in middle and high school. We must move towards awareness-raising at all ages, a family culture, a societal culture of prevention.”
Fear of the diagnosis, fear of the disease, fear of the burden of treatment… there are many obstacles to explaining the renunciation of screening. Yet, in more than nine cases out of ten, breast cancer detected early is cured. “In recent years, we have made enormous progress, says Dr. Benyoucef, and the most significant progress is towards therapeutic de-escalation. It takes place in surgery, since today we try to do less and less axillary dissection of the lymph nodes. And it takes place at the level of chemotherapy: today, in certain patients, we do an analysis of the genes using molecular biology and we have prognostic scores which make it possible to deliver less chemotherapy to the patients.”
Thanks to a trial, the number of weeks of radiotherapy divided by almost two
Furthermore, a national study carried out in particular at the Henri-Becquerel Cancer Center in Rouen made it possible to reduce the number of weeks of radiotherapy treatment by almost half. “Radiotherapy consists of having sessions every day of the week, from Monday to Friday, five times a week for 5 to 6 weeks, continues the doctor. So patients have between 25 and 33 sessions. A little over five years ago, we participated in a national study, HypoG, whose objective was to reduce the total duration of irradiation. For the more than 1,200 patients who participated, we compared two groups: a group in which we did 5 to 6 and a half weeks of radiation, and another group in which we did two weeks less. This was made possible by increasing the dose of radiotherapy a little in each session. And that’s how we managed to reduce the total duration. This is a notable change, particularly in the quality of life of patients. It’s less transportation, it’s less fatigue. This is a very important advantage. And the reduction in the number of radiotherapy sessions means a reduction in the number of medical transports. So it has a significant economic impact for society.”
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