Breast cancer is now epidemic, affecting one in eight women, according
to the American Cancer Society and others. The leading cause of death
in women in their late 30s to early 50s, it’s estimated to have killed
40,000 people in 2008.

Known risk factors for breast cancer-such as age, genetics,
reproductive history and alcohol consumption-account for only half the
cases. (Genetics, the culprit du jour in the media, accounts for just 5
to 10 percent of all cases.) What about the other 50 percent?

A growing body of private, university and government environmental
health research on animals and human populations is implicating the
chemicals and radiation to which women are unwittingly exposed every
day. The suspects include scores of toxic and hormone-disrupting
substances that are listed as known, probable or possible
carcinogens-and thousands of others that (in the U.S., at least) remain
untested for their safety. Among others, they include pesticides,
plastics, consumer-product additives and industrial byproducts.

Moreover, science is finding the causes of breast (and other) cancers
are complex and multi-factored, and the timing and pattern of chemical
exposure are proving as important as dose. While these findings,
focused on causes and prevention, are relatively new and few compared
with much better-funded work on detection and treatment, they merit
further research and a place in the headlines.

Unfortunately, Extra! has found, the major media have downplayed and frequently overlooked this evidence.

Tracking the coverage

To track the extent of coverage of environmental factors in breast cancer causation, Extra!
used the Nexis database to examine a sample of the largest, most
influential news outlets-those with big enough budgets to do regular
science, health and environmental reporting. We studied four newspapers
(USA Today, the New York Times, Los Angeles Times and Washington Post), three newsweeklies (Newsweek, Time and U.S. News & World Report) and four TV networks (ABC, CBS, NBC and CNN)
from 2002 through 2008, reviewing coverage of environmental factors in
breast cancer during an annual event, National Breast Cancer Awareness
Month – October – in each of the seven years. Since its inception in 1985,
this pageant of pink has brought special prominence to the disease.
While the month has been criticized by some as an exercise in corporate
self-promotion, it does provide a predictable news hook and an ideal
time to draw on recent findings to add cause and prevention to the
standard mix of items on cancer rates and risks, detection and
treatment.

Extra! also looked for coverage of
two major scientific metastudies that aggregated numerous peer-reviewed
scientific studies on the environment/breast cancer connection:

• State of the Evidence: The Connection Between Breast Cancer and the Environment,
a summary and explanation of external scientific research plus policy
and research recommendations. First released in 2002 and updated in
2003, 2004, 2006 and 2008 to include new research findings, the latest
edition synthesizes the results of more than 400 studies, runs 147
pages long with 667 references, and was vetted by five independent
experts. It is published by the Breast Cancer Fund, a national
nonprofit focused on environmental and other preventable causes of the
disease, and Breast Cancer Action, a membership organization that
"challenges assumptions and inspires change to end the breast cancer
epidemic."

A veritable catalog of environmental villains, the ’08 edition explains
that the latest data "show that we need to begin to think of breast
cancer causation as a . . . web of often interconnected factors, each
exerting direct and interactive effects on cellular processes on
mammary tissue," and points to growing evidence that "exposure of
fetuses, young children and adolescents to radiation and environmental
chemicals [notably the pesticide DDT] puts them at considerably higher
risk for breast cancer in later life." Though disturbing, the report’s
underlying message is hopeful: "By decreasing exposures to carcinogens
. . . we may continue to lower breast cancer levels-and actually
prevent the devastating disease-in the future."

• Environmental Pollutants and Breast Cancer: Epidemiological Studies,
a review of hundreds of existing studies and databases that identified
some 216 chemicals that induce mammary tumors in animals. Compiled by
researchers at the Silent Spring Institute, a nonprofit scientific
research institute that studies links between the environment and
women’s health, and three other institutions, including Harvard Medical
School, the report was published in May 2007 as a special supplement in
Cancer, the journal of the venerable American Cancer Society.

Stating that "laboratory research provides evidence that environmental
pollutants may contribute to breast cancer risk by damaging DNA,
promoting tumor growth or increasing susceptibility by altering mammary
gland development," the report cautions: "These compounds are widely
detected in human tissues and in environments, such as homes, where
women spend time."

Among other things, the paper found that the relative risks associated
with PAHs (largely from car exhaust) and PCBs were "comparable in
magnitude" to many breast cancer risk factors that have received more
attention, such as age at first full-term pregnancy and inactivity. The
good news: "If these mechanisms similarly affect humans, reducing or
eliminating chemical exposures could have substantial public health
benefits."

The coverage: nearly nil

At no time since the State of the Evidence report began publication in
2002 did any of the major media examined cover or even refer to it.
Similarly, none covered the Cancer special report with the notable exception of the Los Angeles Times,
which published a thorough, nuanced, straightforward front-page article
of nearly 1,500 words by award-winning environmental reporter Marla
Cone ("Common Chemicals Are Linked to Breast Cancer," 5/14/07).

However, the Times seemed to back off Cone’s story a week later, publishing "A Closer Look: Chemicals and Breast Cancer" (5/21/07),
a special report by Mary Beckman in the Health section that appeared
intended not so much to debunk Cone’s article as to reassure a
frightened public. Subheaded "Suspects, but not all perps; a report has
linked chemicals to tumors in animals. But the risks to women are less
clear," it stated that the report’s findings do "not mean women should
stop cooking with canola or cower indoors for fear of getting breast
cancer, experts say."

Stories about or even mentioning breast cancer’s environmental
connections during Breast Cancer Awareness Month were extremely few.
Over the seven Octobers examined, only four articles (Washington Post, 10/23/02, 10/9/07; L.A. Times, 10/9/02 and 10/6/03), an isolated photo and caption (L.A. Times, 10/24/02) and portions of three TV news segments (ABC’s Good Morning America, 10/27/08; CBS’s Early Show, 10/4/06; NBC’s Today, 10/6/05) considered those connections, including the disease’s cause and prevention. There were three brief items (CNN, 10/18/04; L.A. Times, 10/19/04; NBC,
10/24/04) about the federal Sister Study, which is looking at the
environmental and genetic factors in the sisters of women with breast
cancer; CNN also made passing mentions in four segments over the seven years, USA Today made two and NBC one (most of these pieces were about topics other than breast cancer).

Though substantial and informative, both Post pieces and one of the L.A. Times’ had a note of blaming the victim. The Post’s
2002 article on exceptionally high breast cancer rates in wealthy Marin
County, California, noted that "experts say women here are most likely
vulnerable because of something in the county’s lifestyle, rather than
in its water," assigning the cluster most likely to "demographics."

The Post’s 2007 article
reported on findings that childhood exposure to DDT was associated with
a fivefold increase in breast cancer risk in adulthood-but "balanced"
this possibly lifesaving news with concerns that further restrictions
on the pesticide may hobble the fight against malaria. (See Extra!, 9-10/07.)

One L.A. Times story (10/6/03)
on California’s search for the causes of breast and other cancers
through "biomonitoring"-measuring toxins in the human body-gave
credence to the risks posed by chemicals such as flame retardants in
breast milk, but devoted about a third of the 2,000-plus-word piece to
concerns that the findings might scare moms away from breastfeeding
their infants.

ABC, to its credit, had a long
segment on breast doctor Susan Love’s "Army of Women" campaign to
recruit women for human trials to look at breast cancer’s
causes-including environmental ones. CBS and NBC’s
segments – mainly on other aspects of the disease – inquired about
environmental connections, but in both cases the physicians the
networks chose to interview downplayed them.

Notably absent was any coverage in the New York Times or any of the newsweeklies. Time
did have a lengthy cover story on breast cancer’s increase in
developing nations (10/15/07)-but when it suggested that adoption of
"U.S. and European lifestyles" may be behind it, the magazine pointed
the finger only at things like diet and "reproductive habits,"
sidestepping the issue of American-style increases in pollution and
chemical use.

Perhaps the New York Times’ lack of coverage shouldn’t be surprising, considering the historical skepticism of Times science reporter Gina Kolata. In a 1998 article in the Nation (7/6/98), environmental journalist Mark Dowie took a critical look at the Times’
science reporting, singling out Kolata’s many years of work on
controversial topics connecting the environment and health, including
breast cancer. As he told the journal Wild Duck Review (4/99),
her environmental reporting has taken "a hard, pro-technology,
pro-corporate line," noting that Kolata "took a strong position that
breast cancer has no environmental etiology at all."

In a companion video for her article headlined "Environment and Cancer:
The Links Are Elusive" (12/13/05), Kolata stated, "There are people who
say that there may be cancers caused by things in the environment, but
it’s a very small percentage of them, and the importance of them in the
public’s mind has been exaggerated." She later added, "One answer
people don’t want to hear is it’s random bad luck."

The dearth of media coverage was particularly perplexing in October
2008, when the major media missed a perfect news peg: On October 8,
George W. Bush signed the Breast Cancer and Environmental Research Act,
under which Congress funded the establishment of multidisciplinary
research centers to study the potential links between the environment
and breast cancer.

However, the influential outlets did make time and space for such news
as an item on breast cancer survivors getting beauty make-overs (NBC Today, 10/15/08) and an explanation (NBC
Today, 10/13/08) of how "you can shop for a cure. When you buy
everything from pink jump ropes to golf clubs, you can stay fit while
fighting breast cancer all at the same time."

Same old story

Evolving research discoveries may make theories about breast and other
cancers more robust over time, but the dearth of coverage of breast
cancer’s environmental links seems to have changed little since before
2001. That year, Brown University sociologist Phil Brown and colleagues
published their study Print Media Coverage of Environmental Causation
of Breast Cancer. The researchers looked at 40 years (1961-2001) of
coverage of breast cancer in two major papers, the three major
newsweeklies, four popular science magazines and eight women’s
magazines, and found that only 12 percent of science magazines, 10
percent of women’s magazines, 5 percent of newspapers and less than 5
percent of newsweeklies ever mentioned possible environmental
causation, focusing mostly on an individual’s personal responsibility
for avoiding the disease.

When it comes to breast cancer, why is it so hard to get the most
influential media to pay attention to the possibility that, in addition
to better-understood risks, unnatural substances entering women’s
bodies might also be a factor?

"It wasn’t for lack of trying," said Shannon Coughlin, communications
director for the Breast Cancer Fund. According to Coughlin, major
mainstream reporters seem to hold environmental health science findings
to an especially high standard of proof. "Chemical regulation goes by
the idea that a chemical is innocent until proven guilty, which places
a terrible burden on us to prove harm," she said.

Environmental health research is less certain by definition, added
Julia Brody, executive director of the Silent Spring Institute and lead
author of the Cancer
report: "The standard breast cancer risks [e.g., reproductive history
and diet] are things we can ask people about," whereas "people don’t
know what’s in their drinking water and in their air."

Thus journalists "say there’s no smoking gun," Jeanne Rizzo, the Breast Cancer Fund’s executive director, told Extra!. "If there’s no sensational, direct cause and effect, they’re not interested."

She added: "We need to change the conversation to see the
interconnectedness of things. The media need to be willing to go out on
a limb and talk about complicated [causality]."

Silent Spring’s Brody noted that even her institute’s hometown paper, the Boston Globe,
passed on the Environmental Pollutants story: "They said, ‘There’s no
proof.’ We say, ‘We don’t think we’ll find proof; we think we need to
act on the weight of the evidence as it evolves.’ . . . We waited too
long on tobacco smoke, we waited too long on lead."

Rizzo pointed to the Women’s Health Initiative study, which found a
direct connection between artificial hormone replacement therapy (HRT)
and breast cancer (Extra!,
9-10/02). "We should have learned from HRT that when you remove an
endocrine-disrupting chemical from women, we get less breast cancer,"
she said. "We need to extrapolate from that-what other exposures are
similar that we should study? It’s not rocket science." She added that
because that health study was government-issued, "the media jumped all
over it."

Consider the source

Indeed, science news – and spokespeople – with the imprimatur of large,
establishmentarian organizations are taken more seriously, said retired
journalist Arlie Schardt, founder of Environmental Media Services, a
nonprofit communications organization that until 2005 helped
lesser-known scientists gain media coverage. Schardt explained that for
efficiency’s sake, reporters tend to turn for sources to "the usual
suspects," who reflect "traditional viewpoints," particularly when
seeking feedback and "balance" on the validity of emerging science. 

This fallback position may be due to the general "lack of knowledge" of
environmental health science on the part of reporters and editors,
according to former L.A. Times reporter Marla Cone, who is now editor-in-chief of Environmental Health News.
She noted that breast cancer is typically the beat of medical
reporters, who tend to interview physicians – and neither these reporters
nor their sources are "accustomed to looking at this type of data."

Schardt, a former Newsweek
editor and later Al Gore’s press secretary, has found that scientists
tend to be very cautious when pressed by reporters to make "definitive
claims" about research findings. Not wanting to seem like advocates,
they "cloak their quotes with a lot of qualifications," reinforcing the
uncertainty or controversy of newer scientific ideas in the resulting
news stories.

Rizzo noted, "Reporters sometimes imply to us that our science isn’t
valid because we have a perspective. But so does the American Cancer
Society."

Then there is what Brody calls "the connection between this field of
science and the consumer economy." Magazines, TV and newspapers all
depend on advertising from companies that "produce the compounds
targeted in our studies," she pointed out.

Schardt puts it more bluntly: "Scientists are always attacked by
industries with a stake" in the science. In his experience, "They’ll
pull out all the stops to discredit the source." That makes journalists
more likely to shy away.

And there is something at stake: corporate power. Breast cancer
activists not only want more research dollars devoted to environmental
causes, they endorse strengthening consumer protection laws to ensure
the safety of the chemicals in question, as is now taking place in
Europe under the 2007 REACH (Registration, Evaluation, Authorization
and Restriction of Chemicals) legislation.

Or as Cone, who observes that possible environmental angles are
typically left out of reporting on the many other forms of cancer, puts
it: "There is such a wealth of data on chemical exposures and their
relationship to disease. . . . It should be brought up in every story."

This article was published by Extra!, FAIR’s monthly magazine.