Returning to work is a key outcome for women of working age who survive breast cancer. A pilot study in Luxembourg shows that it is feasible to securely link the national cancer registry, occupational health records and questionnaire data, and that among linked participants 77.1% returned to work after their leave.
What was already known
Breast cancer strongly affects women of working age, so returning to work matters as much as oncological outcomes. Studying it requires individual-level data combining clinical and occupational information, which is hard to obtain. Luxembourg offers a distinctive setting: a young population and many cross-border workers, creating both challenges and opportunities for such studies.
What this work adds
This is a cross-sectional pilot linking three sources: Luxembourg’s National Cancer Registry (RNC), occupational health records from the multisectoral STM service and a 27-item self-administered questionnaire. It included women diagnosed between 2013 and 2018, under 65 years of age, employed under Luxembourgish labour law and followed by STM. Participants were identified through STM records, completed an electronic questionnaire and gave explicit consent for linkage via REDCap. Deterministic linkage between RNC and STM relied on a shared pseudonymisation service.
Main results
Of 452 women contacted, 171 completed the questionnaire and gave consent (a 38% response rate); 96 were successfully linked to the RNC dataset. Having Luxembourgish nationality or residence was associated with successful linkage (p < 0.001). Among linked participants, 74 (77.1%) returned to work after breast cancer-related leave. Those who returned were significantly younger at diagnosis, and most resumed work in the same sector and company.
What it means
Pseudonymised linkage across three real-world data sources, including a population-based cancer registry, is feasible and provides valuable insight into return to work. The main barriers were cross-border residency and heterogeneous cancer definitions between sources. A population-based approach gives a more complete picture of work trajectories and can inform surveillance and occupational health policies in highly mobile European regions.
Reading from a breast unit
For a breast unit, coordinating clinical information with occupational health and offering early guidance on return to work, especially for younger patients, helps plan the transition back to employment.
Reference: Lima B, Mafra A, Schnell M, Prévotat L, Georges M, Majery N, et al. Understanding return to work after breast cancer through real-world data linkage framework: a Luxembourg digital oncology use case. ESMO real world data and digital oncology, 2026. DOI: 10.1016/j.esmorw.2026.100782
