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June 1, 2000
Breast Cancer: Cause and Controversy
Plague of Neglect
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She spent a full hour outlining what she considers to be the real Bay Area cancer nightmare.
It's not about Marin, Luce said, it's about women in areas such as predominantly African-American, low-income Bayview/Hunters Point (Yahoo map) in San Francisco.
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Women are much less likely to get diagnosed early on in this community, are less likely to have regular mammograms, and when they get the disease the outcome is worse. | |
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Cancer Cluster?
The Navy has now pulled out, leaving behind a coveted swath of real estate, but the expense of a full-scale cleanup is holding back waterfront redevelopment.
The shipyard has also become a symbol of how little attention is being paid to an area that by all accounts must have at least as many environmental exposures to cancer as would San Rafael or Sausalito.
Subsequent studies appeared to bolster the notion that San Francisco had a relatively high incidence for two types of cancers -- breast and cervical -- affecting African American women in Hunters Point.
Cervical cancer is considered less likely than other types to have an environmental component. Cancer in fatty tissues such as the breast, however, are a different story, since many toxins are fat-soluble and so may disproportionately affect breast tissue.
"Environmental activists in Hunters Point felt they were being subjected to high cancer risks because people there were living in a toxic dump, which is basically true," Luce said, recalling the origins of a nascent San Francisco toxic-awareness movement in the late '80s.
Inconstant numbers
But it was later discovered that higher breast cancer rates affected only African American women under age 50. In subsequent follow-up studies, even these apparent differences have disappeared.
"It's not a real thing," Luce said of the suspected Hunters Point/Bayview cancer cluster (download report -- requires Adobe Acrobat).
"All said and done, it's not at all clear there's any higher risk of breast cancer based on where you live," she added. Nor did she see anything surprising about the Marin County statistics.
"In Marin there's a higher rate because Marin is so overwhelmingly white," she said. "It's demographics and lifestyle. It isn't where you live that makes the difference. Where ever you find affluent, professional white women with few kids and lots of college education, you find higher rates of breast cancer."
Barbara Brenner of the San Francisco-based nonprofit Breast Cancer Action remains convinced that cancer in Hunters Point and many other lower-income communities with "must have something to do with the toxic soup in which they swim."
Studies to prove it tend to be expensive, hard to design and time-consuming, but Brenner argues that there is no choice but to keep focusing on environmental factors "to understand what among them is contributing to breast and other cancers, and then how the risk can be reduced."
Next: Blacks Take the Hit
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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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