WHO: Slight cancer risk after Japan nuke accident


LONDON (AP) — Two years after Japan's nuclear plant disaster, an international team of experts said Thursday that residents of areas hit by the highest doses of radiation face an increased cancer risk so small it probably won't be detectable.


In fact, experts calculated that increase at about 1 extra percentage point added to a Japanese infant's lifetime cancer risk.


"The additional risk is quite small and will probably be hidden by the noise of other (cancer) risks like people's lifestyle choices and statistical fluctuations," said Richard Wakeford of the University of Manchester, one of the authors of the report. "It's more important not to start smoking than having been in Fukushima."


The report was issued by the World Health Organization, which asked scientists to study the health effects of the disaster in Fukushima, a rural farming region.


On March 11, 2011, an earthquake and tsunami knocked out the Fukushima plant's power and cooling systems, causing meltdowns in three reactors and spewing radiation into the surrounding air, soil and water. The most exposed populations were directly under the plumes of radiation in the most affected communities in Fukushima, which is about 150 miles (240 kilometers) north of Tokyo.


In the report, the highest increases in risk are for people exposed as babies to radiation in the most heavily affected areas. Normally in Japan, the lifetime risk of developing cancer of an organ is about 41 percent for men and 29 percent for women. The new report said that for infants in the most heavily exposed areas, the radiation from Fukushima would add about 1 percentage point to those numbers.


Experts had been particularly worried about a spike in thyroid cancer, since radioactive iodine released in nuclear accidents is absorbed by the thyroid, especially in children. After the Chernobyl disaster, about 6,000 children exposed to radiation later developed thyroid cancer because many drank contaminated milk after the accident.


In Japan, dairy radiation levels were closely monitored, but children are not big milk drinkers there.


The WHO report estimated that women exposed as infants to the most radiation after the Fukushima accident would have a 70 percent higher chance of getting thyroid cancer in their lifetimes. But thyroid cancer is extremely rare and one of the most treatable cancers when caught early. A woman's normal lifetime risk of developing it is about 0.75 percent. That number would rise by 0.5 under the calculated increase for women who got the highest radiation doses as infants.


Wakeford said the increase may be so small it will probably not be observable.


For people beyond the most directly affected areas of Fukushima, Wakeford said the projected cancer risk from the radiation dropped dramatically. "The risks to everyone else were just infinitesimal."


David Brenner of Columbia University in New York, an expert on radiation-induced cancers, said that although the risk to individuals is tiny outside the most contaminated areas, some cancers might still result, at least in theory. But they'd be too rare to be detectable in overall cancer rates, he said.


Brenner said the numerical risk estimates in the WHO report were not surprising. He also said they should be considered imprecise because of the difficulty in determining risk from low doses of radiation. He was not connected with the WHO report.


Some experts said it was surprising that any increase in cancer was even predicted.


"On the basis of the radiation doses people have received, there is no reason to think there would be an increase in cancer in the next 50 years," said Wade Allison, an emeritus professor of physics at Oxford University, who also had no role in developing the new report. "The very small increase in cancers means that it's even less than the risk of crossing the road," he said.


WHO acknowledged in its report that it relied on some assumptions that may have resulted in an overestimate of the radiation dose in the general population.


Gerry Thomas, a professor of molecular pathology at Imperial College London, accused the United Nations health agency of hyping the cancer risk.


"It's understandable that WHO wants to err on the side of caution, but telling the Japanese about a barely significant personal risk may not be helpful," she said.


Thomas said the WHO report used inflated estimates of radiation doses and didn't properly take into account Japan's quick evacuation of people from Fukushima.


"This will fuel fears in Japan that could be more dangerous than the physical effects of radiation," she said, noting that people living under stress have higher rates of heart problems, suicide and mental illness.


In Japan, Norio Kanno, the chief of Iitate village, in one of the regions hardest hit by the disaster, harshly criticized the WHO report on Japanese public television channel NHK, describing it as "totally hypothetical."


Many people who remain in Fukushima still fear long-term health risks from the radiation, and some refuse to let their children play outside or eat locally grown food.


Some restrictions have been lifted on a 12-mile (20-kilometer) zone around the nuclear plant. But large sections of land in the area remain off-limits. Many residents aren't expected to be able to return to their homes for years.


Kanno accused the report's authors of exaggerating the cancer risk and stoking fear among residents.


"I'm enraged," he said.


___


Mari Yamaguchi in Tokyo and AP Science Writer Malcolm Ritter in New York contributed to this report.


__


Online:


WHO report: http://bit.ly/YDCXcb


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Las Vegas Strip shooting suspect is arrested in L.A.









A man suspected in a deadly car-to-car shooting in the heart of the Las Vegas Strip was arrested Thursday at a Studio City apartment complex, bringing an end to a weeklong manhunt.


Los Angeles police and FBI agents surrounded the suburban apartment complex in the 4100 block of Arch Drive about noon and ordered Ammar Harris to surrender. Officers said there was a woman inside the apartment where he was holed up; she was not arrested.


Harris, 26, is being held on suspicion of murder and is expected to be extradited back to Nevada.





"This arrest is much more than just taking Ammar Harris," said Las Vegas Sheriff Doug Gillespie, speaking at police headquarters near the Strip. "The citizens of our community as well as tourists who visit and work in the Las Vegas Valley are entitled to a safe community."


Harris — described by law enforcement officials as a man with an "extensive and violent criminal history" — is accused of being the gunman in the Feb. 21 shooting that killed three people, including Kenneth Cherry Jr., an Oakland native and rapper known as Kenny Clutch.


Las Vegas police said Harris opened fire from his Ranger Rover on Cherry's Maserati on Las Vegas Boulevard after an altercation at a valet stand at the Aria hotel resort.


The Maserati then sped into the intersection at Flamingo Road, where it rammed a Yellow Cab, which erupted in flames near the mega-wattage casinos of the Bellagio, the Flamingo and Ceasars Palace. The explosion killed the taxi driver and passenger inside.


Cherry and a passenger in his Maserati were taken to a hospital, where Cherry was pronounced dead. Four other vehicles were involved in the fiery crash, which left three other people with injuries.


"What I can tell you is that Mr. Harris' behavior was unlike any other I've seen, and I've been in this community in law enforcement for 32 years," Clark County Dist. Atty. Steve Wolfson said.


"I cannot imagine anything more serious than firing a weapon from a moving vehicle into another moving vehicle on a corner such as Las Vegas Boulevard and Flamingo."


Even in a city accustomed to spectacle, the shooting and collision were shocking.


On the night of the shooting, Harris was accompanied by three people in his Range Rover, none considered suspects, said Lt. Ray Steiber of the Las Vegas Metropolitan Police Department. On Saturday, Las Vegas police found Harris' black Range Rover at an apartment complex in the city. The district attorney charged Harris with murder even though he could not be located, and a federal magistrate signed off on a charge of fleeing the jurisdiction.


Federal court documents show Las Vegas homicide detectives suspected that Harris may have fled to California because his phone showed he made calls in the state.


According to law enforcement sources, Harris operated as a pimp in Las Vegas. In a video released by Las Vegas police, Harris flashed a fistful of $100 bills as he bragged about the money. He boasted about money, guns, expensive cars and run-ins with the law on social media accounts, authorities said.


On one social media site, using the name Jai'duh, someone authorities believe was Harris posted pictures of stacks of $100 bills and a Carbon 15 pistol.


Harris' record includes a 2010 arrest in Las Vegas on suspicion of pimping-related offenses of pandering with force and sexual assault. He has previously been arrested on suspicion of a variety of crimes in South Carolina and Georgia, authorities said.


Harris is slated to appear in a downtown Los Angeles courtroom Monday for an extradition proceeding.


richard.winton@latimes.com


john.glionna@latimes.com


kate.mather@latimes.com


Glionna reported from Las Vegas. Times staff writer Andrew Blankstein contributed to this report.





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Japan to Begin Restarting Idled Nuclear Plants


Junji Kurokawa/Associated Press


Japan's Prime Minister Shinzo Abe delivers his policy speech at the lower house of parliament in Tokyo.







TOKYO -- Japan will begin restarting its idled nuclear plants once new safety guidelines are in place later this year, Prime Minister Shinzo Abe said Thursday, moving to ensure a stable energy supply despite public safety concerns after the Fukushima disaster.




In a speech to Parliament, Mr. Abe pledged to restart nuclear plants that pass the new guidelines, which are expected to be adopted by a newly created independent watchdog agency, the Nuclear Regulation Authority, as early as July.


All but two of Japan’s 50 operable nuclear reactors were shut down following the March 2011 triple meltdown at the Fukushima Daiichi plant, which spewed radiation across northern Japan after a huge earthquake and tsunami knocked out vital cooling systems. Responding to public safety concerns, leaders from the previous Democratic Party government had vowed to slowly phase out nuclear power by the 2030s in favor of cleaner alternatives like solar and wind.


However, Mr. Abe, who took power after his Liberal Democratic Party won national elections in December, has vowed to scrap that planned phase out, saying that Japan needs stable and cheap electricity from nuclear power to compete economically.


On Thursday, Mr. Abe said that Japan had learned the need for tougher safety standards from the Fukushima accident, which forced more than 100,000 people to evacuate. He said the new safety standards will be enforced "without compromise."


However, he did not specify when plants that meet those new standards will be allowed to resume operations. Mr. Abe also said Japan will continue seeking energy alternatives in order to reduce its dependence on nuclear power, even without going so far as to eliminate it.


In the case of the Fukushima Daiichi meltdown, the plant’s operator, Tokyo Electric Power Company, recently admitted that it had failed to take stronger measures to prevent disasters for fear of inviting lawsuits or protests against its nuclear plants.


In the October 2012 report, Tepco said that before the accident it had been afraid to consider the risk of such a large tsunami, fearing admissions of risk could result in public pressure to shut plants down. The report was intended to showcase internal changes as the government considers when to allow other reactors to resume operation.


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American Idol Reveals Its Top 10 Women






American Idol










02/27/2013 at 10:45 PM EST







From left: Randy Jackson, Mariah Carey, Ryan Seacrest, Nicki Minaj, Keith Urban


Michael Becker/FOX


American Idol's's list of the top 10 women is complete!

After the first week of sudden-death rounds, the judges gave their stamp of approval to five more female singers Wednesday night. And they sent five others home.

Keep reading to find out who's in and who's out on Idol ...

Here are the five contestants who are moving on in the competition:

1. Zoanette Johnson: The Tulsa resident, 20, was the first to be put through by the judges, who showered her with praise for singing a spirited version of "Circle of Life" from The Lion King. Keith Urban declared her "queen of the jungle." Nicki Minaj told Zoanette, "You make me so emotional ... You're the person we're going to remember tonight."

2. Aubrey Cleland: After singing a slowed-down version of Beyoncé's "Sweet Dreams," Mariah Carey told Cleland, 19, "You're limitless." Nicki and Randy Jackson pointed out her commercial appeal. "Lookin' like a current artist, soundin' like one, feelin' like one," said Nicki of the performance.

3. Candice Glover: Taking on Aretha Franklin's "(You Make Me Feel Like) A Natural Woman" paid off for the singer, 23, who earned a standing ovation from Keith. Randy said she was "one of my favorite singers in the whole competition."

4. Breanna Steer: "You're extremely marketable and gorgeous and talented," Mariah told the singer, 18, after she sang a dramatic version of Jazmine Sullivan's "Bust Your Windows" that had Randy wanting to sign her up for a recording contract. "You got the whole package," he said. "You brought so much drama."

5. Janelle Arthur: She beat out the other country singer in the competition, Rachel Hale, for the final spot in the women's top 10 after singing Lady Antebellum's "Just a Kiss." Though Randy called Arthur, 23, his "favorite country singer in this competition," the other judges questioned her song choice. "[The song] doesn't give you a chance to really soar," Keith said. "The melody kept pulling you back."

These five will join the five female finalists announced last week – Kree Harrison, Amber Holcomb, Adriana Latonio, Angela Miller and Tenna Torres – as well as the five men – Charlie Askew, Curtis Finch Jr., Paul Jolley, Elijah Liu and Devin Velez. Ten more guys will sing Thursday (8 p.m. ET) and five will move on to round out season 12's top 20.

Did the judges make the right decisions? Sound off in the comments below.

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Medicare paid $5.1B for poor nursing home care


SAN FRANCISCO (AP) — Medicare paid billions in taxpayer dollars to nursing homes nationwide that were not meeting basic requirements to look after their residents, government investigators have found.


The report, released Thursday by the Department of Health and Human Services' inspector general, said Medicare paid about $5.1 billion for patients to stay in skilled nursing facilities that failed to meet federal quality of care rules in 2009, in some cases resulting in dangerous and neglectful conditions.


One out of every three times patients wound up in nursing homes that year, they landed in facilities that failed to follow basic care requirements laid out by the federal agency that administers Medicare, investigators estimated.


By law, nursing homes need to write up care plans specially tailored for each resident, so doctors, nurses, therapists and all other caregivers are on the same page about how to help residents reach the highest possible levels of physical, mental and psychological well-being.


Not only are residents often going without the crucial help they need, but the government could be spending taxpayer money on facilities that could endanger people's health, the report concluded. The findings come as concerns about health care quality and cost are garnering heightened attention as the Obama administration implements the nation's sweeping health care overhaul.


"These findings raise concerns about what Medicare is paying for," the report said.


Investigators estimate that in one out of five stays, patients' health problems weren't addressed in the care plans, falling far short of government directives. For example, one home made no plans to monitor a patient's use of two anti-psychotic drugs and one depression medication, even though the drugs could have serious side effects.


In other cases, residents got therapy they didn't need, which the report said was in the nursing homes' financial interest because they would be reimbursed at a higher rate by Medicare.


In one example, a patient kept getting physical and occupational therapy even though the care plan said all the health goals had been met, the report said.


The Office of Inspector General's report was based on medical records from 190 patient visits to nursing homes in 42 states that lasted at least three weeks, which investigators said gave them a statistically valid sample of Medicare beneficiaries' experiences in skilled nursing facilities.


That sample represents about 1.1 million patient visits to nursing homes nationwide in 2009, the most recent year for which data was available, according to the review.


Overall, the review raises questions about whether the system is allowing homes to get paid for poor quality services that may be harming residents, investigators said, and recommended that the Centers for Medicare & Medicaid Services tie payments to homes' abilities to meet basic care requirements. The report also recommended that the agency strengthen its regulations and ramp up its oversight. The review did not name individual homes, nor did it estimate the number of patients who had been mistreated, but instead looked at the overall number of stays in which problems arose.


In response, the agency agreed that it should consider tying Medicare reimbursements to homes' provision of good care. CMS also said in written comments that it is reviewing its own regulations to improve enforcement at the homes.


"Medicare has made significant changes to the way we pay providers thanks to the health care law, to reward better quality care," Medicare spokesman Brian Cook said in a statement to AP. "We are taking steps to make sure these facilities have the resources to improve the quality of their care, and make sure Medicare is paying for the quality of care that beneficiaries are entitled to."


CMS hires state-level agencies to survey the homes and make sure they are complying with federal law, and can require correction plans, deny payment or end a contract with a home if major deficiencies come to light. The agency also said it would follow up on potential enforcement at the homes featured in the report.


Greg Crist, a Washington-based spokeswoman for the American Health Care Association, which represents the largest share of skilled nursing facilities nationwide, said overall nursing home operators are well regulated and follow federal guidelines but added that he could not fully comment on the report's conclusions without having had the chance to read it.


"Our members begin every treatment with the individual's personal health needs at the forefront. This is a hands-on process, involving doctors and even family members in an effort to enhance the health outcome of the patient," Crist said.


Virginia Fichera, who has relatives in two nursing homes in New York, said she would welcome a greater push for accountability at skilled nursing facilities.


"Once you're in a nursing home, if things don't go right, you're really a prisoner," said Fichera, a retired professor in Sterling, NY. "As a concerned relative, you just want to know the care is good, and if there are problems, why they are happening and when they'll be fixed."


Once residents are ready to go back home or transfer to another facility, federal law also requires that the homes write special plans to make sure patients are safely discharged.


Investigators found the homes didn't always do what was needed to ensure a smooth transition.


In nearly one-third of cases, facilities also did not provide enough information when the patient moved to another setting, the report found.


___


On the Web:


The OIG report: http://1.usa.gov/VaztQm


The Medicare nursing home database: http://www.medicare.gov/NursingHomeCompare/search.aspx?bhcp=1&AspxAutoDetectCookieSupport=1


___


Follow Garance Burke on Twitter at —http://twitter.com/garanceburke.


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Eric Garcetti showed political savvy during busy student years









Fourth in a series of articles focusing on key periods in the lives of the mayoral hopefuls.


Ben Jealous still recalls walking into a Columbia University meeting of a new group called Black Men for Anita Hill and seeing a half-Jewish, half-Mexican kid from Los Angeles leading the discussion.


"What's he doing here?" he asked the professor who organized the meeting.





"Honestly brother," the teacher replied, "he's the only one here I'm certain will really work hard."


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It was Jealous' first exposure to Eric Garcetti, a committed young progressive known on campus for gliding between different worlds and liberal causes. As a political science major at Columbia, Garcetti patched plaster and painted walls in low-income apartments in Harlem while also serving as the president of an exclusive literary society known for its wealthy membership. He led a men's discussion group on gender and sexuality, ran successfully for student government, and wrote and performed in musicals.


His busy student years offered hints of the future political persona that would later help him win a Los Angeles City Council seat and emerge as a leading candidate for mayor. As he pursued countless progressive causes — improved race relations in New York City, democracy in Burma and human rights in Ethiopia — Garcetti also exhibited a careful stewardship of his image and a desire to get along with everyone.


Some of his critics complain that he is confrontation averse, and say his chameleon-like abilities are political. Others complain that he has lost touch with his activist roots, citing his recent advocacy for a plan to allow taller and bigger buildings in Hollywood despite strong opposition from some community members.


But Jealous, who went on to study with Garcetti at Oxford, where they were both Rhodes scholars, remembers his classmate as "authentically committed" to social justice and naturally at ease in different settings. That was a valuable trait in early 1990s New York City, when tensions between whites and blacks were high, said Jealous, who is now the president of the National Assn. for the Advancement of Colored People. Against a backdrop of racial violence, including the stabbing of the Rev. Al Sharpton in Brooklyn in 1991, "there was an urgent need to build bridges," he said.


On Columbia's campus, Garcetti pushed to involve more men in Take Back the Night protests against sexual violence and tracked hate crimes as president of the National Student Coalition Against Harassment. He also worked against homelessness and founded the Columbia Urban Experience, a program that exposes incoming freshmen to city life through volunteerism.


Judith Russell, a Columbia professor who taught Garcetti in a yearlong urban politics course, remembers him as a skilled organizer. "Eric was one of the best people I've ever met at getting people to agree," she said.


He was also ambitious. Russell says she wrote countless recommendation letters for Garcetti, who was always applying for some new opportunity. "For most people I have a file or two. For Eric I have a folder," she said.


Even as a student, Garcetti went to great lengths to guard his image and public reputation. In a 1991 letter to a campus newspaper, a 20-year-old Garcetti sought a retraction of a quote that he acknowledged was accurate. A reporter wrote that Garcetti called owners of a store that declined to participate in a Columbia-sponsored can recycling program "assholes." Garcetti said the comment was off the record.


"I would ask, then, if you would retract the quote, not because of the morality of my position, rather the ethics of the quoting," he wrote.


That self-awareness came partly from being raised in a politically active family. Back in Los Angeles, his father was mounting a successful campaign for county district attorney. His mother, the daughter of a wealthy clothier, ran a community foundation. Her father, who had been President Lyndon B. Johnson's tailor, made headlines in the 1960s when he took out a full-page ad in the New York Times calling on Johnson to exit the Vietnam War.


Garcetti's family wealth allowed him to carry on the legacy of political activism. While attending L.A.'s exclusive Harvard School for Boys, he traveled to Ethiopia to deliver medical supplies. In college, while other students worked at summer jobs, he traveled twice to Burma to teach democracy to leaders of the resistance movement.


In 1993, after receiving a master's degree from Columbia's School of International and Public Affairs, Garcetti departed for Oxford. There he met Cory Booker, a fellow Rhodes scholar who is now the mayor of Newark, N.J., and a likely candidate for the U.S. Senate. Garcetti, Booker said, "was one of those guys who would be in the pub at midnight talking passionately about making a better world."


In England, Garcetti worked with Amnesty International and also met his future wife, Amy Wakeland, another Rhodes scholar with activist leanings. Garcetti remembers being impressed when Wakeland missed President Clinton's visit to the Rhodes House at Oxford because she was on the streets protesting tuition hikes. Her worldview aligned with his, he told friends.


In his second year at Oxford, Garcetti persuaded student leaders to join him in a hunger strike after the passage of Proposition 187, the 1994 California ballot measure that denied immigrants access to state healthcare and schools.


Looking back, he sees the hunger strike as a bit of youthful folly. "We were young," Garcetti said. "Was a fast an ocean away going to overturn 187? No. But in my book, whether it's me in Los Angeles seeing an injustice across an ocean or vice versa, you have to stand up and be heard."





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India Ink: Deadly Fire Breaks Out at Market in Kolkata







KOLKATA, India (AP) — A fire broke out at an illegal six-story plastics market in the Indian city of Kolkata early Wednesday morning, killing at least 19 people, police said.




The blaze, which started before 4 a.m., was likely caused by a short circuit, said West Bengal fire minister Javed Khan. The fire was under control by mid-morning, he said, but toxic gases being released by the blaze were hampering rescue efforts.


A police official, speaking on condition of anonymity because he was not authorized to speak to the media, said at least 19 people had died. He said police were looking for the owner of the building, which was filled with dozens of small shops selling various plastic products.


Another 10 people were hospitalized in critical condition and the death toll was expected to rise, Khan said.


He called the scene of the fire "an illegal, unauthorized market."


However, local residents said the market had been operating in the building for nearly 40 years. They said there was only one entrance to the building, which made rescue efforts difficult.


The building housed several warehouses on its upper floors, where chemicals, paper and plastics were stored.


Police said the victims were porters working in the market, who also slept there at night. Eighteen of the dead were men.


Mamata Banerjee, the state's top elected official, who visited the site soon after the blaze was brought under control, issued an ultimatum to the building's owners to install fire safety equipment within two months.


Banerjee said the previous government that ruled the state for more than three decades had allowed the building to operate without any permits or safety measures.


She said she has ordered police, fire service and the city administration to file a report on the cause of the blaze and take steps to prevent the recurrence of such fires.


In December 2011, at least 93 people died in a deadly fire in a hospital in Kolkata. Soon after that, Banerjee had promised that her government would crackdown on lax safety procedures in public buildings.


Safety regulations are routinely ignored in India, where fire stairways and evacuation drills are rare. Even if fire extinguishers are present, they are commonly several years old and almost never serviced.


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Bobby Brown Sentenced to 55 Days in Jail in Drunk Driving Case















02/26/2013 at 09:30 PM EST



Bobby Brown has been sentenced to 55 days in jail and four years probation in his most recent drunk driving arrest.

Brown, 44, was pulled over in Studio City, Calif., on Oct. 24 for driving erratically and was arrested when the officer detected "a strong scent of alcohol." He was charged with DUI and driving on a suspended license.

He was also arrested for driving under the influence in March of 2012.

Brown pled no contest to the charges on Tuesday, reports TMZ. He was also ordered to complete an 18-month alcohol treatment program.

The singer, who married Alicia Etheredge in Hawaii in June of 2012, must report to jail by March 20.

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Advanced breast cancer edges up in younger women


CHICAGO (AP) — Advanced breast cancer has increased slightly among young women, a 34-year analysis suggests. The disease is still uncommon among women younger than 40, and the small change has experts scratching their heads about possible reasons.


The results are potentially worrisome because young women's tumors tend to be more aggressive than older women's, and they're much less likely to get routine screening for the disease.


Still, that doesn't explain why there'd be an increase in advanced cases and the researchers and other experts say more work is needed to find answers.


It's likely that the increase has more than one cause, said Dr. Rebecca Johnson, the study's lead author and medical director of a teen and young adult cancer program at Seattle Children's Hospital.


"The change might be due to some sort of modifiable risk factor, like a lifestyle change" or exposure to some sort of cancer-linked substance, she said.


Johnson said the results translate to about 250 advanced cases diagnosed in women younger than 40 in the mid-1970s versus more than 800 in 2009. During those years, the number of women nationwide in that age range went from about 22 million to closer to 30 million — an increase that explains part of the study trend "but definitely not all of it," Johnson said.


Other experts said women delaying pregnancy might be a factor, partly because getting pregnant at an older age might cause an already growing tumor to spread more quickly in response to pregnancy hormones.


Obesity and having at least a drink or two daily have both been linked with breast cancer but research is inconclusive on other possible risk factors, including tobacco and chemicals in the environment. Whether any of these explains the slight increase in advanced disease in young women is unknown.


There was no increase in cancer at other stages in young women. There also was no increase in advanced disease among women older than 40.


Overall U.S. breast cancer rates have mostly fallen in more recent years, although there are signs they may have plateaued.


Some 17 years ago, Johnson was diagnosed with early-stage breast cancer at age 27, and that influenced her career choice to focus on the disease in younger women.


"Young women and their doctors need to understand that it can happen in young women," and get checked if symptoms appear, said Johnson, now 44. "People shouldn't just watch and wait."


The authors reviewed a U.S. government database of cancer cases from 1976 to 2009. They found that among women aged 25 to 39, breast cancer that has spread to distant parts of the body — advanced disease — increased from between 1 and 2 cases per 100,000 women to about 3 cases per 100,000 during that time span.


The study was published Tuesday in the Journal of the American Medical Association.


About one in 8 women will develop breast cancer in their lifetime, but only 1 in 173 will develop it by age 40. Risks increase with age and certain gene variations can raise the odds.


Routine screening with mammograms is recommended for older women but not those younger than 40.


Dr. Len Lichtenfeld, the American Cancer Society's deputy chief medical officer, said the results support anecdotal reports but that there's no reason to start screening all younger women since breast cancer is still so uncommon for them.


He said the study "is solid and interesting and certainly does raise questions as to why this is being observed." One of the most likely reasons is probably related to changes in childbearing practices, he said, adding that the trend "is clearly something to be followed."


Dr. Ann Partridge, chair of the federal Centers for Disease Control and Prevention's advisory committee on breast cancer in young women, agreed but said it's also possible that doctors look harder for advanced disease in younger women than in older patients. More research is needed to make sure the phenomenon is real, said Partridge, director of a program for young women with breast cancer at the Harvard-affiliated Dana-Farber Cancer Institute.


The study shouldn't cause alarm, she said. Still, Partridge said young women should be familiar with their breasts and see the doctor if they notice any lumps or other changes.


Software engineer Stephanie Carson discovered a large breast tumor that had already spread to her lungs; that diagnosis in 2003 was a huge shock.


"I was so clueless," she said. "I was just 29 and that was the last thing on my mind."


Carson, who lives near St. Louis, had a mastectomy, chemotherapy, radiation and other treatments and she frequently has to try new drugs to keep the cancer at bay.


Because most breast cancer is diagnosed in early stages, there's a misconception that women are treated, and then get on with their lives, Carson said. She and her husband had to abandon hopes of having children, and she's on medical leave from her job.


"It changed the complete course of my life," she said. "But it's still a good life."


____


Online:


JAMA: http://jama.ama-assn.org


CDC: http://www.cdc.gov/cancer/breast/index.htm


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Cost of San Onofre nuclear plant outage exceeds $400 million









The parent company of Southern California Edison, operator of the troubled San Onofre nuclear plant, reported that the costs of the yearlong outage at the plant had ballooned to more than $400 million by the end of 2012.


The hefty price tag for the darkened plant includes inspections, repairs and purchasing replacement power.


Edison International officials fielded questions Tuesday from analysts about the plant's extended shutdown and the possibility that federal regulators will require the plant to go through a lengthy license amendment process before returning to service.





The utility also indicated Tuesday that the company has looked into what repairs could be done to restore both units to full power, and was told by the steam generator manufacturer, Mitsubishi Heavy Industries, that the job of replacing "significant portions" of the system could take more than five years to complete.


The seaside facility, one of only two nuclear power plants in California, has been shut down for just over a year because of unusual wear on steam generator tubes that carry radioactive water. One tube leaked in January 2012, releasing a small amount of radioactive steam.


Edison and San Diego Gas & Electric — which has a 20% stake in the plant — spent more than $780 million replacing the steam generators, which ratepayers are now repaying.


Edison officials also took a shot Tuesday at elected officials who have accused the company of knowingly installing defective equipment.


Edison has proposed restarting the less-damaged of the plant's two units and operating it at 70% power, which the company argued would alleviate the conditions that led to the wear. The U.S. Nuclear Regulatory Commission is reviewing the proposal.


The plant powered about 1.4 million households in Southern California before the outage.


The report also heralded a potentially protracted dispute between Edison and Mitsubishi over the warranty on the equipment that limited payouts to $138 million, of which the company has paid out $45 million to date. Edison contends that the warranty cap should not apply because of unusual circumstances at San Onofre — Mitsubishi disagrees.


Edison Chief Executive Ted Craver said the company "bristles" at allegations made publicly by Sen. Barbara Boxer (D-Calif.) and U.S. Rep. Ed Markey (D-Mass.) that the company was aware of design flaws in the steam generators before installation and did not make fixes to avoid triggering a time-consuming license amendment.


"This is just not accurate, and it injects politics into a process that should be free from it," Craver said during Tuesday's earnings call.


The lawmakers cited a leaked confidential report written by Mitsubishi when they made their claims. The NRC has said it will make a redacted version of the report public, but has not yet done so.


Environmental group Friends of the Earth contends that Edison should be required to go through a license amendment process, including public hearings, before the plant can restart.


The NRC has yet to decide on that question, but agency staff asked Edison to demonstrate that the unit proposed for restart can operate safely at its full licensed power, raising the possibility that the commission would require a license amendment for it to operate at 70% power.


In a response submitted Monday, Edison argued that 70% power is, in fact "normal steady state full power," drawing indignation from activists who are pushing for a license amendment.


The company said that the "clear purpose" of the technical specification governing tube integrity is "to ensure that the … tubes will retain their integrity over the range of operating conditions to which they will be subjected. In this case, that range is limited to 70% power."


But the response also promised to provide an analysis by March 15 showing that the unit could operate at 100% power without danger of a tube rupture.


Edison officials were scheduled to meet with NRC staff Wednesday.


abby.sewell@latimes.com





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