Despite growing scientific evidence linking certain working conditions to a portion of breast cancers, a woman diagnosed with this disease must prove that her occupation played a predominant role in its onset to receive recognition and compensation. A breast cancer is considered "occupational" if it is a direct consequence of professional exposure to a physical, chemical, or biological risk, or results from the conditions of carrying out the activity. For breast cancer—central to the prevention campaign Pink October—ionizing radiation is classified as "carcinogenic" by the World Health Organization's anti-cancer agency (IARC), and night work is "probably" carcinogenic. Other factors, such as chemical substances, are being studied by the French Agency for Health Safety (Anses), which will present its findings by the end of 2027. Breast cancer is the most deadly cancer among women, with nearly 13,000 annual deaths in France, and it is a multifactorial disease. Recognizing the occupational origin of a breast cancer is difficult because it is not on the list of diseases for which a link with a profession is presumed. Without being listed in a "table"—which allows for a lump-sum compensation when specific criteria are met—each woman must prove in court the "direct and essential" link between her illness and her work. "Essential" means that there are no other factors that could contribute to the development of cancer: it is very complicated to demonstrate," explains Dr. Alain Randon, a doctor from the Ramazzini association who analyzes the professional exposure of patients accompanied by trade unions and victim associations in their request for recognition. "Unfortunately, we only give a favorable opinion to initiate a legal procedure for one out of two cases: those almost devoid of 'confounding factors,' personal factors that could favor the development of cancer: heavy smoking, a family history of breast, ovarian, or uterine cancer..." The weight of "confounding" factors is a major challenge. "We look at the weight of these 'confounding' factors compared to professional exposure. The fact of having worked 20 years at night, having been exposed to ionizing radiation, being stressed—which weakens the immune defenses—will be major compared to having smoked ten packs of cigarettes a year, having gained weight, or taking the pill for five to ten years," explains the doctor. Unions—especially CFDT Grand-Est, a pioneer on the subject—and associations are seeking to improve the jurisprudence. "The more cases are recognized, the more it will encourage others to be recognized," estimates the doctor, because "the Ministry of Labor is not ready to publish new occupational disease tables, there is a total blockage." These tables, resulting from negotiations between unions and employers, must be validated by the ministry. For now, the occupational origin of breast cancer has only been recognized for a few women, after years of procedure: nurses in Metz exposed to ionizing radiation in radiology, a parquetry worker exposed to night work and endocrine disruptors in Agen, or in July, a flight attendant who had accumulated nights and exposure to cosmic radiation during long-haul flights in Bayonne. Her lawyer, Elisabeth Leroux, points out a "blaming" discourse towards her clients: "You smoked, you drink too much, you didn't breastfeed, you are too fat: it's your fault." While working three nights a week for ten years triples the risk—but this risk returns to zero once a day job is resumed—"these women are never asked about their potential occupational risks," laments the lawyer, who represents nurses, police officers, night guards, factory workers, waiters... However, "when they have spent their entire career at night or have been massively exposed, without protection, to endocrine disruptors, we can demonstrate that this exposure surpasses personal risk factors: the judges understand this," explains Me Leroux. However, the long and complex procedures discourage many women who must "already fight against the disease" and take care of their family, because these cancers often affect young people.