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June 1, 2000
Breast Cancer: Cause and Controversy
By Carl Hall
For Nancy Rubin, director of the Marin County Department of Health and Human Services, it's high time for some answers.
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Her community -- the overwhelmingly white, well-to-do population (marin.org/) of Marin County -- is rallying against what they perceive as a nationwide epidemic of breast cancer, one that is crashing down hardest on that idyllic stretch of forested countryside just north of the Golden Gate Bridge.
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Why was Susan Dotto of San Rafael -- with no family history of breast cancer, who worked for years in a superclean office job -- diagnosed with the disease shortly after her 35th birthday? | |
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In Marin, the rate has been closer to one in six (nccc.org/), the highest overall rate of Bay Area breast cancer by a wide margin -- 154.4 cases a year on average per 100,000 women, vs. 100.3 cases per 100,000 in San Francisco and 107.2 in the East Bay's Alameda County.
Part of the reason Marin's rates are so high is simple: Breast cancer is far more common among white women than minorities, and Marin has a higher proportion of white women.
In the latest tally, 130.5 annual cases of breast cancer were reported for white women in the Bay Area, compared with 97.1 cases among African Americans and 71.1 for Asians/Pacific Islanders.
But these ethnic variations do not shed much light on why Susan Dotto of San Rafael, with no family history of breast cancer, who worked for years in a "superclean" office job before taking on the full-time career of homemaker, was diagnosed with breast cancer shortly after her 35th birthday.
Now 37, she came through chemotherapy, mastectomy and reconstruction, and now is "doing great" with no hint of recurrence.
But she is still troubled by the fact that she has no idea what made her sick in the first place.
Next: Difficult Questions, Elusive Answers
Carl Hall is a San Francisco Chronicle science writer and the San Francisco Newspaper Guild union rep.
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Breast Cancer: CAUSE & CONTROVERSY by Carl Hall photographs by Pico  SIDEBARS: Photo Gallery: Breast cancer survivors carry on. (Pico) Long Island: A mammoth research effort and its critics. (Hall) Risk factors offer questions and answers. (Wilson)
Toxic Links: How do we know if a chemical is dangerous? (Wilson)
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