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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Wendy Greuel acquired a love of politics from working with Tom Bradley

In the early 1980s, Wendy Greuel was at a crossroads. In one direction was the family building supply company housed in a dusty North Hollywood warehouse. The other way, a career at Los Angeles City Hall in Mayor Tom Bradley's administration beckoned.

Bright, young and ambitious, Greuel had balanced duties on the high school cheerleading squad and as student body president with part-time work at Frontier Building Supply — where she kept the books, drove a forklift and answered the phone that sometimes rang for her mother's side business, the White Lace Inn.

The 17-year-old Greuel, raised a Republican, was star-struck when she first met the Democratic mayor during a youth leadership ceremony atop City Hall. "Here was this 6-foot-5 inspirational leader," she said, "and as I've jokingly said, I fell in love that day."

When Bradley handed her an award, her course was set. Over the next decade, she would join a group of young aides who drove the five-term mayor's agenda, from the inspiring run-up to the 1984 Olympic Games to the difficult rebuilding after the city's 1992 riots. Her portfolio at City Hall — homelessness, housing, child care and AIDS — took the young UCLA graduate from the conservative enclaves of the Valley into the most destitute corners of South and East L.A.

"I used to call her the mayor of hopeless causes," former Bradley Deputy Press Secretary Dee Dee Myers said. "She had all the really tough, intractable issues … and she dove in."

Now a leading contender to follow her political hero to City Hall's top office, Greuel says she learned from Bradley the skills the job demands: a tireless work ethic, an ability to glide between city factions and a relentless focus on basic city services.

"What I really learned from all of those years was that the details matter," said Greuel, whose admiration for Bradley's zeal in reporting potholes led her to style herself as the "pothole queen" when she later represented the San Fernando Valley on the City Council.

But critics contend that as Greuel, currently the city's controller, raised her political profile she shied away from the imaginative and idealistic projects that were a hallmark of her years in the Bradley administration. Councilman Richard Alarcon, who worked with Greuel in Bradley's office, said he endorsed Greuel's chief rival, Eric Garcetti, after watching her gravitate toward politically safe initiatives.

"When Wendy was with Mayor Bradley, it was all about action — all about creating projects, ideas, L.A.'s Best," Alarcon said, alluding to the acclaimed after-school program that has now expanded to more than 150 Los Angeles schools. "We were doing a lot more than filling potholes."

Greuel says Bradley inspired her "passion to fight for social justice" and to stand up for the most vulnerable. But some saw her City Council focus as tending toward the more narrow — modernizing parking meters and synchronizing traffic signals.

Councilman Bernard C. Parks, the former police chief who is supporting Greuel's rival Jan Perry, said that Bradley created the downtown skyline, rebuilt the airport and brought the Olympics to L.A.

"He had a variety of legacies — most of them were big-picture ideas," Parks said. "In Wendy's era on the council…it was more of the mechanics of dealing with transportation and potholes."

In the early years however, Greuel's drive on those social issues was unquestioned.

Olivia Mitchell, Greuel's first boss in Bradley's youth development office, described Greuel as the ultimate "go-getter." At night, Greuel volunteered to be Mitchell's driver, ferrying her boss to community gatherings, prisoner probation meetings and continuation high schools in her brown Camaro.

"She wanted to know everything I knew and the people I knew," Mitchell said. Later, colleagues would tease her about being willing to "go to the opening of an envelope," Greuel said.

Former Bradley aide Donna Bojarsky said Greuel sought out "high-value, low-glamour" assignments. She also cultivated long-term political relationships that have helped her stack up endorsements in the current race.

Fellow Bradley aide Kerman Maddox noted that she was the one staffer who went to every group's party.

"We're talking 1980s Los Angeles, a tough, gritty, racially-balkanized city," Maddox said. "We'd tease her: 'How many white girls are hanging out in South L.A? It's just you.' But that's her.... She could move from camp to camp, faction to faction, because she got along with everyone."

Greuel was tasked with developing programs to deal with the city's burgeoning homeless population, which was threatening Bradley's drive to redevelop downtown's Bunker Hill. Greuel was in the thick of the issue when tensions grew over a proliferation of urban encampments, including the much-publicized "Justiceville."

Ted Hayes, Justiceville's leader and an advocate for the homeless, recalled that he and Bradley were at sharp odds because "I ran like a buzz saw right smack dab into his plans." Greuel began showing up at the camp, wandering among the plywood and cardboard structures in her prim navy suits.

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IHT Rendezvous: IHT Quick Read: Feb. 26

NEWS Italian voters delivered a rousing anti-austerity message and a strong rebuke to the existing political order in national elections on Monday, plunging the country into political paralysis after results failed to produce a clear winner. Rachel Donadio reports from Rome.

The U.S. secretary of state, John Kerry, said on Monday that the Obama administration has been considering new steps to increase support for the Syrian opposition and hasten the departure of President Bashar al-Assad, and that some of them would be decided at an international conference in Rome this week. Michael R. Gordon reports from Berlin, and Anne Barnard from Beirut, Lebanon.

Britain’s most senior Roman Catholic cleric, Cardinal Keith O’Brien, announced his resignation on Monday, a day after being accused of “inappropriate acts” with priests, saying he would not attend the conclave to elect a new pope. Rachel Donadio reports from Vatican City, and John F. Burns from London.

Talks between Iran and six world powers over its nuclear program resume on Tuesday after a break of eight months, but there is a general atmosphere of gloom about their prospects for success, even if narrowly defined. Steven Erlanger reports from Almaty, Kazakhstan.

About 30 percent of heart attacks, strokes and deaths from heart disease can be prevented in people at high risk if they switch to a Mediterranean diet rich in olive oil, nuts, beans, fish, fruits and vegetables, and even drink wine with meals, a large and rigorous new study has found. Gina Kolata reports.

The furniture giant Ikea joined a growing list of brands that have been touched by Europe’s food scandal on Monday and withdrew its signature Swedish meatballs from its markets and cafeterias across most of Europe after one batch was found to contain traces of horse meat. Stephen Castle reports from London, and Andrew Higgins from Brussels.

The Japanese government is set to loosen its grip on Japan Tobacco, one of the world’s largest tobacco companies, by selling a third of its stake in a sale that will net the country about $10 billion. Hiroko Tabuchi reports from Tokyo.

FASHION Sites like Marc Jacobs and House of Holland hope that social networking will improve their online sales. Fleur Britten reports.

ARTS Wolfgang Sawallisch, one of the last of the old-school German conductors, who led the Philadelphia Orchestra for nearly a decade and the Bavarian State Opera in Munich for two decades before that, died on Friday at his home in Grassau, Germany. He was 89. Annette Midgette reports.

SPORTS For two countries that have a long history of tangling politically, often extending that rivalry into sports, the cooperation this week between the U.S. and Russian ski teams at the Rosa Khutor Alpine Resort could strike many as unexpected. Brian Pinelli reports from Krasnaya Polyana, Russia.

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The Bachelor's Sean Lowe Reveals Final Two

TV Watch

The Bachelor

02/25/2013 at 10:30 PM EST

From left: AshLee, Lindsay and Catherine

Kevin Foley/ABC(3)

And then there were two.

After three incredible dates in Thailand with the remaining women, The Bachelor's Sean Lowe faced a difficult decision at the end of Monday's episode: Would he send home AshLee, Catherine or Lindsay?

Keep reading to find out who got a rose – and who was left heartbroken ...

Sean said goodbye to early favorite AshLee in a surprising elimination that left her virtually speechless.

Visibly upset, AshLee left Sean's side without saying goodbye. She even asked him to not walk her to the waiting car that would take her away.

But Sean did get to explain. "I thought it was you from the very beginning," he said. "This was honestly the hardest decision I've ever had to make ... I think the world of you. I did not want to hurt you."

"This wasn't a silly game for me," AshLee said as the car drove away. "This wasn't about a joy ride. It wasn't about laughing and joking and having fun."

She added: "It's hard to say goodbye to Sean because I let him in ... It's the ultimate [rejection]."

Check back Tuesday morning for Sean Lowe's blog post to read all about his Thailand dates and why he chose to send AshLee home

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Koop, who transformed surgeon general post, dies

With his striking beard and starched uniform, former Surgeon General Dr. C. Everett Koop became one of the most recognizable figures of the Reagan era — and one of the most unexpectedly enduring.

His nomination in 1981 met a wall of opposition from women's groups and liberal politicians, who complained President Ronald Reagan selected Koop, a pediatric surgeon and evangelical Christian from Philadelphia, only because of his conservative views, especially his staunch opposition to abortion.

Soon, though, he was a hero to AIDS activists, who chanted "Koop, Koop" at his appearances but booed other officials. And when he left his post in 1989, he left behind a landscape where AIDS was a top research and educational priority, smoking was considered a public health hazard, and access to abortion remained largely intact.

Koop, who turned his once-obscure post into a bully pulpit for seven years during the Reagan and George H.W. Bush administrations and who surprised both ends of the political spectrum by setting aside his conservative personal views on issues such as homosexuality and abortion to keep his focus sharply medical, died Monday at his home in Hanover, N.H. He was 96.

An assistant at Koop's Dartmouth College institute, Susan Wills, confirmed his death but didn't disclose its cause.

Dr. Richard Carmona, who served as surgeon general a decade ago under President George W. Bush, said Koop was a mentor to him and preached the importance of staying true to the science even if it made politicians uncomfortable.

"He set the bar high for all who followed in his footsteps," Carmona said.

Although the surgeon general has no real authority to set government policy, Koop described himself as "the health conscience of the country" and said modestly just before leaving his post that "my only influence was through moral suasion."

A former pipe smoker, Koop carried out a crusade to end smoking in the United States; his goal had been to do so by 2000. He said cigarettes were as addictive as heroin and cocaine. And he shocked his conservative supporters when he endorsed condoms and sex education to stop the spread of AIDS.

Chris Collins, a vice president of amFAR, the Foundation for AIDS Research, said many people don't realize what an important role Koop played in the beginning of the AIDS epidemic.

"At the time, he really changed the national conversation, and he showed real courage in pursuing the duties of his job," Collins said.

Even after leaving office, Koop continued to promote public health causes, from preventing childhood accidents to better training for doctors.

"I will use the written word, the spoken word and whatever I can in the electronic media to deliver health messages to this country as long as people will listen," he promised.

In 1996, he rapped Republican presidential hopeful Bob Dole for suggesting that tobacco was not invariably addictive, saying Dole's comments "either exposed his abysmal lack of knowledge of nicotine addiction or his blind support of the tobacco industry."

Although Koop eventually won wide respect with his blend of old-fashioned values, pragmatism and empathy, his nomination met staunch opposition.

Foes noted that Koop traveled the country in 1979 and 1980 giving speeches that predicted a progression "from liberalized abortion to infanticide to passive euthanasia to active euthanasia, indeed to the very beginnings of the political climate that led to Auschwitz, Dachau and Belsen."

But Koop, a devout Presbyterian, was confirmed after he told a Senate panel he would not use the surgeon general's post to promote his religious ideology. He kept his word.

In 1986, he issued a frank report on AIDS, urging the use of condoms for "safe sex" and advocating sex education as early as third grade.

He also maneuvered around uncooperative Reagan administration officials in 1988 to send an educational AIDS pamphlet to more than 100 million U.S. households, the largest public health mailing ever.

Koop personally opposed homosexuality and believed sex should be saved for marriage. But he insisted that Americans, especially young people, must not die because they were deprived of explicit information about how HIV was transmitted.

Koop further angered conservatives by refusing to issue a report requested by the Reagan White House, saying he could not find enough scientific evidence to determine whether abortion has harmful psychological effects on women.

Koop maintained his personal opposition to abortion, however. After he left office, he told medical students it violated their Hippocratic oath. In 2009, he wrote to Senate Majority Leader Harry Reid, urging that health care legislation include a provision to ensure doctors and medical students would not be forced to perform abortions. The letter briefly set off a security scare because it was hand delivered.

Koop served as chairman of the National Safe Kids Campaign and as an adviser to President Bill Clinton's health care reform plan.

At a congressional hearing in 2007, Koop spoke about political pressure on the surgeon general post. He said Reagan was pressed to fire him every day, but Reagan would not interfere.

Koop, worried that medicine had lost old-fashioned caring and personal relationships between doctors and patients, opened his institute at Dartmouth to teach medical students basic values and ethics. He also was a part-owner of a short-lived venture, drkoop.com, to provide consumer health care information via the Internet.

Koop was born in the New York City borough of Brooklyn, the only son of a Manhattan banker and the nephew of a doctor. He said by age 5 he knew he wanted to be a surgeon and at age 13 he practiced his skills on neighborhood cats.

He attended Dartmouth, where he received the nickname Chick, short for "chicken Koop." It stuck for life.

Koop received his medical degree at Cornell Medical College, choosing pediatric surgery because so few surgeons practiced it.

In 1938, he married Elizabeth Flanagan, the daughter of a Connecticut doctor. They had four children, one of whom died in a mountain climbing accident when he was 20.

Koop was appointed surgeon-in-chief at Children's Hospital in Philadelphia and served as a professor at the University of Pennsylvania School of Medicine.

He pioneered surgery on newborns and successfully separated three sets of conjoined twins. He won national acclaim by reconstructing the chest of a baby born with the heart outside the body.

Although raised as a Baptist, he was drawn to a Presbyterian church near the hospital, where he developed an abiding faith. He began praying at the bedside of his young patients — ignoring the snickers of some of his colleagues.

Koop's wife died in 2007, and he married Cora Hogue in 2010.

He was by far the best-known surgeon general and for decades afterward was still a recognized personality.

"I was walking down the street with him one time" about five years ago, recalled Dr. George Wohlreich, director of the College of Physicians of Philadelphia, a medical society with which Koop had longstanding ties. "People were yelling out, 'There goes Dr. Koop!' You'd have thought he was a rock star."

___

Ring reported from Montpelier, Vt. Cass reported from Washington. AP Medical Writers Lauran Neergaard in Washington and Mike Stobbe in New York contributed to this report.

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Healthcare overhaul may threaten California's safety net

Millions of uninsured Californians will gain medical coverage under the national healthcare overhaul beginning in January, but Guadalupe Luna won't be one of them.

Luna, an illegal immigrant and tamale vendor in Los Angeles, doesn't qualify. So she will continue going to the clinic where she has received free care for more than 20 years: Los Angeles County's Hudson Comprehensive Health Center. There, publicly funded doctors will help manage her diabetes and high cholesterol.

An estimated 3 million to 4 million Californians — about 10% of the state's population — could remain uninsured even after the healthcare overhaul law takes full effect. The burden of their care will fall to public hospitals, county health centers and community clinics. And those institutions may be in jeopardy.

County health leaders and others say the national health law has had the unintended consequence of threatening the financial stability of the state's safety net.

Newly insured patients who no longer have to rely on public hospitals and clinics may seek care elsewhere, meaning a loss in revenue, they say. And under the federal law, some of the funding that goes to safety-net hospitals is also set to decrease.

Now, as the state scrambles to create the new healthcare infrastructure, Gov. Jerry Brown is proposing to take back another crucial pot of money that counties have depended on for more than two decades to care for the uninsured.

"Safety net providers are imperative ... and some of their funding streams are in serious danger," said Lucien Wilson, director of the Insure the Uninsured Project, a consumer organization.

Melissa Stafford Jones, president and chief executive of the California Assn. of Public Hospitals and Health Systems, said many of the patients who are uninsured now still won't have coverage next year. "Those communities are still going to need care, and we need to have a safety net to serve them," she said.

Under the healthcare overhaul, the state could enroll as many as 1.4 million additional residents in Medi-Cal, its program for the poor and disabled, and sign up 2.1 million others for subsidized private insurance through a marketplace known as Covered California, according to a recent UC Berkeley report.

About a quarter of those left uninsured will be undocumented immigrants, and nearly three-quarters will be U.S. citizens or green-card holders, according to the report. Some already qualify for Medi-Cal but don't receive it; others will be eligible to buy subsidized healthcare through Covered California but won't be able to afford it.

Martin Garcia, 39, a U.S. citizen with five children, said he doesn't know if he could get Medi-Cal now or what he might qualify for next year. Garcia lost his job and insurance in 2010 and recently started going to the Hudson clinic in Los Angeles because of stomach pains.

Garcia needs hernia surgery, which he said he will receive at L.A. County-USC Medical Center, a public hospital. He said he was relieved to learn that he could get free healthcare through the county. Without it, he said, "I really don't know what I would do. I would probably head to Mexico."

Even with massive outreach by the state, it will take time for eligible people to learn about and enroll in the new coverage. During the early years, the demand for public health services is expected to remain high, and counties will be responsible, said report author Ken Jacobs, chairman of the UC Berkeley Center for Labor Research and Education.

To pay for care for the uninsured, counties have long relied on revenue from sales tax and vehicle license fees — a pot of money known as realignment funds. In fiscal year 2012, the funds amounted to an estimated $1.3 billion.

Brown argues that counties will no longer need all that money because so many of the uninsured will gain coverage under the federal law. At the same time, the governor's administration has said, the state will need the funds if it is going to run the expanded Medi-Cal program.

"There is going to be a fundamental shift in responsibility of healthcare to the state from the counties," said Toby Douglas, director of the state Department of Health Care Services. "There needs to be a realignment of county dollars."

The Legislative Analyst's Office released a report this month recommending that the state run the Medi-Cal expansion and that it take control of some of the realignment funding to help pay for that expansion.

But county health directors argue that the state is just trying to balance its budget on the backs of safety-net systems. They say the counties already struggle to meet demand and contend the state should not take the money before it's clear how many people will sign up for Medi-Cal and how much savings there will be for counties.

"The state needs money, and they see this as an opportunity to get it," said Mitch Katz, director of the Los Angeles County Department of Health Services. "I think it is completely unreasonable."

If the state does take back the realignment funding, counties such as Los Angeles that run their own hospitals and clinics could be seriously affected, he said.

Alex Briscoe, director of Alameda County's Health Care Services Agency, said the state proposal shows a "fundamental misunderstanding" of the pressures facing safety-net systems. About 100,000 people might remain uninsured in the county, he said. "If the state takes the money, who is going to pay that care?"

In addition, Briscoe said the state doesn't have any justification for taking the money because the Medi-Cal expansion is 100% covered by the federal government for the first three years.

Who ends up paying doesn't matter to Luna, the tamale vendor. But without the Hudson clinic, the 43-year-old said, her diabetes would spiral out of control.

"I don't have anywhere else to go," she said. "I have to come here."

Luna is one of about 42,000 patients who go to the clinic and urgent care center to manage their chronic diseases, get their children vaccinated, check their eyes and monitor their pregnancies.

Hudson's administrator, Michael Mills, said that even after the healthcare law takes full effect, the clinic will be vital to the community. Nearly half its patients now are uninsured, and many will remain without coverage next year.

"Those are our patients," Medical Director Rona Molodow said. "Those are the people the county has traditionally served."

anna.gorman@latimes.com

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South Korea’s Park Geun-hye Warns North Against Nuclear Pursuits

SEOUL, South Korea — Park Geun-hye, the daughter of a late military strongman, was sworn in Monday as South Korea’s first female president, warning North Korea that the primary victim of its pursuit of nuclear weapons and long-range missiles will be the isolated country itself.

“North Korea’s recent nuclear test is a challenge to the survival and future of the Korean people, and there should be no mistake that the biggest victim will be none other than North Korea itself,” Ms. Park said in her inaugural address in front of the National Assembly building in Seoul.

She urged North Korea to abandon its nuclear ambitions without delay, “instead of wasting its resources on nuclear and missile development and continuing to turn its back to the world in self-imposed isolation.”

Her motorcade’s arrival Monday at the presidential Blue House marked a triumphant moment not just for Ms. Park but for her family. Ms. Park, 61, was returning to her childhood home, 34 years after the assassination of her father, Park Chung-hee, a divisive figure even now. Mr. Park’s 18-year rule was credited with rapidly raising South Korea’s economy from postwar devastation, but his iron-fisted governance was increasingly maligned as the country evolved toward democracy.

Ms. Park was elected in December thanks largely to the support of South Koreans in their 50s and older. Many younger voters were vehemently opposed to her candidacy, saying she represented a return to the past.

North Korea, meanwhile, has again become a prime national security concern. A week before Ms. Park’s election, the North launched a satellite into orbit in defiance of United Nations resolutions. On Feb. 12, it conducted a third nuclear test. The two events have heightened fears that years of efforts by Washington and its allies to rein in the North’s nuclear ambitions have failed, even as Pyongyang appears to have made progress toward achieving the capability to make long-range nuclear missiles.

Speaking Monday before a large crowd — which earlier had been entertained by the rapper Psy, famous for the song “Gangnam Style” — Ms. Park also addressed economic concerns, a major issue in the election. She said her tasks as president would include “achieving economic rejuvenation, the happiness of the people and the flourishing of our culture.”

In a comment reminiscent of her father, she called for a “second miracle on the Han River.” Seoul, which straddles the Han, began transforming itself into an industrialized metropolis under her father, who sought economic growth at all costs and nurtured a handful of family-controlled companies, such as Samsung and Hyundai, as the engines of an export-driven economy.

Now, as his daughter takes office, one of the biggest complaints among ordinary South Koreans is of widening economic inequality, particularly those conglomerates’ overpowering influence on smaller businesses — a grievance Mr. Park addressed in her speech, saying that a second Han River “miracle” should be based on “economic democratization.”

She promised policies designed to strengthen small and medium-sized enterprises so that “such businesses can prosper alongside large companies.” She said, “By rooting out various unfair practices and rectifying the misguided habits of the past which have frustrated small business owners and small and medium-sized enterprises, we will provide active support to ensure that everyone can live up to their fullest potential, regardless of where they work or what they do for a living.”

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Les Misérables Stars Oscar Gowns: Love 'Em or Leave 'Em

Stylewatch
Style News Now

02/24/2013 at 09:30 PM ET

Jason Merritt/Getty, John Shearer/AP

Though Anne Hathaway and Amanda Seyfried got a thumbs-up from the PEOPLE StyleWatch team for their bubbly red carpet demeanors and terrific hair and makeup, their dresses inspired decidedly mixed reactions.

Hathaway said she picked her baby pink Prada column just hours before the ceremony. The dress had a fun, criss-crossed back and the Tiffany & Co. diamonds she draped herself with were spectacular, but the bodice of the dress was, er, possibly not safe for work when seen up close on the red carpet.

Seyfried’s lilac Alexander McQueen gown with silver leaf embroidery was a sophisticated pick (and a challenging one: she mentioned that the corset was “pushing her organs out of her body”) but the fit wasn’t exact — and if you’re reading, Amanda, we’d really love to see you in more color.

RELATED PHOTOS: The Best Dressed List

Since we’re ambivalent about these dresses, we want you to vote in the polls below, and tell us: What do you think of Hathaway and Seyfried’s Oscar gowns? If you don’t like them, what would you want to see them wear?

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FDA approves new targeted breast cancer drug

WASHINGTON (AP) — The Food and Drug Administration has approved a first-of-a-kind breast cancer medication that targets tumor cells while sparing healthy ones.

The drug Kadcyla from Roche combines the established drug Herceptin with a powerful chemotherapy drug and a third chemical linking the medicines together. The chemical keeps the cocktail intact until it binds to a cancer cell, delivering a potent dose of anti-tumor poison.

Cancer researchers say the drug is an important step forward because it delivers more medication while reducing the unpleasant side effects of chemotherapy.

"This antibody goes seeking out the tumor cells, gets internalized and then explodes them from within. So it's very kind and gentle on the patients — there's no hair loss, no nausea, no vomiting," said Dr. Melody Cobleigh of Rush University Medical Center. "It's a revolutionary way of treating cancer."

Cobleigh helped conduct the key studies of the drug at the Chicago facility.

The FDA approved the new treatment for about 20 percent of breast cancer patients with a form of the disease that is typically more aggressive and less responsive to hormone therapy. These patients have tumors that overproduce a protein known as HER-2. Breast cancer is the second most deadly form of cancer in U.S. women, and is expected to kill more than 39,000 Americans this year, according to the National Cancer Institute.

The approval will help Roche's Genentech unit build on the blockbuster success of Herceptin, which has long dominated the breast cancer marketplace. The drug had sales of roughly $6 billion last year.

Genentech said Friday that Kadcyla will cost $9,800 per month, compared to $4,500 per month for regular Herceptin. The company estimates a full course of Kadcyla, about nine months of medicine, will cost $94,000.

FDA scientists said they approved the drug based on company studies showing Kadcyla delayed the progression of breast cancer by several months. Researchers reported last year that patients treated with the drug lived 9.6 months before death or the spread of their disease, compared with a little more than six months for patients treated with two other standard drugs, Tykerb and Xeloda.

Overall, patients taking Kadcyla lived about 2.6 years, compared with 2 years for patients taking the other drugs.

FDA specifically approved the drug for patients with advanced breast cancer who have already been treated with Herceptin and taxane, a widely used chemotherapy drug. Doctors are not required to follow FDA prescribing guidelines, and cancer researchers say the drug could have great potential in patients with earlier forms of breast cancer

Kadcyla will carry a boxed warning, the most severe type, alerting doctors and patients that the drug can cause liver toxicity, heart problems and potentially death. The drug can also cause severe birth defects and should not be used by pregnant women.

Kadcyla was developed by South San Francisco-based Genentech using drug-binding technology licensed from Waltham, Mass.-based ImmunoGen. The company developed the chemical that keeps the drug cocktail together and is scheduled to receive a $10.5 million payment from Genentech on the FDA decision. The company will also receive additional royalties on the drug's sales.

Shares of ImmunoGen Inc. rose 2 cents to $14.32 in afternoon trading. The stock has ttraded in a 52-wek range of $10.85 to $18.10.

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Mahony answers questions under oath about clergy sex abuse cases

A "relatively unflappable" Cardinal Roger Mahony answered questions under oath for more than 3 1/2 hours Saturday about his handling of clergy sex abuse cases, according to the lawyer who questioned the former archbishop.

"He remained calm and seemingly collected at all times," said attorney Anthony De Marco, who represents a man suing the Los Angeles Archdiocese over abuse he alleges he suffered at the hands of a priest who visited his parish in 1987.

Mahony has been deposed many times in the past, but Saturday's session was the first time he had been asked about recently released internal church records that show he shielded abusers from law enforcement.

De Marco declined to detail the questions he asked or the answers the cardinal provided, citing a judge's protective order.

The deposition occurred just before Mahony was to board a plane for Italy to vote in the conclave that will elect the next pope. In a Twitter post Friday, Mahony wrote that it was "just a few short hours before my departure for Rome."

Church officials did not return requests for comment.

The case, set for trial in April, concerns a Mexican priest, Nicholas Aguilar Rivera. Authorities believe he molested at least 26 children during a nine-month stay in Los Angeles.

Recently released church files show Aguilar Rivera fled to Mexico after a top Mahony aide, Thomas Curry, warned him that parents were likely to go the police and that he was in "a good deal of danger." Aguilar Rivera remains a fugitive in Mexico.

The archdiocese had agreed that Mahony could be questioned for four hours about the Aguilar Rivera case and 25 other priests accused in the same period. De Marco said he did not get to ask everything he wanted and would seek additional time after the cardinal returned from the Vatican.

Past depositions of Mahony have eventually become public, and De Marco said he would follow court procedures to seek the release of a transcript of Saturday's deposition.

Meanwhile, a Catholic organization Saturday delivered a petition with thousands of signatures asking that Mahony recuse himself from the conclave in Rome.

The group, Catholics United, collected nearly 10,000 signatures making "a simple request" that the former archbishop of Los Angeles not participate in the process because of the priest abuse scandals that happened under his watch, said Chris Pumpelly, communications director for Catholics United.

The petition was delivered Saturday to St. Charles Borromeo in North Hollywood, where the cardinal resides. It was accepted by a church staff member.

After delivering the petition, organizers attended Mass at the parish to pray for healing and for the future of the church.

harriet.ryan@latimes.com

Times staff writer Rick Rojas contributed to this report.

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