and concluded that a woman’s risk of developing breast cancer did not increase according
to the amount of time she spent in the county,
suggesting that there is nothing about the land
itself that triggers the disease.
“If geography itself plays a role, that is, a
specific environmental factor at play in Marin,
researchers have not yet identified it,” Willis
says. In coming years the M WS will continue
to analyze the potential role of carcinogens
like the heavy metals cadmium and bisphenol
A (often contained in plastic water bottles, food
containers and toys) in breast cancer risk. The
saliva samples donated in the M WS may also
help experts evaluate certain environmental
factors over time.
THE MORTALITY RATE
Perhaps the best news of all: “Women with
breast cancer in Marin have lower mortality
rates on a stage-for-stage basis when compared
to other Bay Area hospitals, to other counties
in the state of California and to the National
Cancer Database,” Halberg says.
According to data disseminated by the
California Cancer Registry just last August,
the age-adjusted mortality rate in 2006–2010
(the most recent five-year data) for breast
cancer in white women is lower in Marin than
in the state overall — by 13 percent. In other
words, more women were diagnosed here in
that period, but fewer were dying.
Normally diagnosis and outcome trend
together, making this scenario yet another
Marin anomaly. Once again, factors unique to
Marin may explain why: residents here have
superior access to world-class medical exper-
tise, with a high number of physicians per
capita who provide personalized, coordinated
and integrated treatment. “Mortality in Marin
is lower at least in part because of better medi-
cal care,” Halberg confirms. “You don’t have to
go to an academic medical center or even cross
a bridge to have access to the latest research.”
The Marin Cancer Institute and Kaiser
Permanente are both certified by the National
Consortium of Breast Centers as Breast Centers
of Excellence, offering entree to clinical trials,
a multidisciplinary tumor board automatically
providing each patient with a second opinion,
and state-of-the-art technology.
It’s been about two decades since the intro-
duction of the pink ribbon, arguably one of the
most recognizable health-related symbols in
the world. Over that time, with the immense
amount of knowledge already gathered about
breast cancer in this county, Marin women are
overwhelmingly coming to view that signature
loop not as some sort of pastel skull-and-cross-
bones evoking dread of what may come, but as
an emblem of unvarnished hope for what can
yet be conquered. M
A woman’s risk of developing breast cancer did not
increase according to the amount of time she spent in the
county, suggesting that there is nothing about the land
itself that triggers the disease.
