Cellar victim Kampusch raped, starved in film of ordeal

VIENNA (Reuters) – A new film based on the story of Austrian kidnap victim Natascha Kampusch shows her being repeatedly raped by the captor who beat and starved her during the eight-and-a-half years that he kept her in a cellar beneath his house.

Kampusch was snatched on her way to school at the age of 10 by Wolfgang Priklopil and held in a windowless cell under his garage near Vienna until she escaped in 2006, causing a sensation in Austria and abroad. Priklopil committed suicide.

Kampusch had always refused to respond to claims that she had had sex with Priklopil, but in a German television interview on her 25th birthday last week said she had decided to reveal the truth because it had leaked out from police files.

The film, “3,096 Days” – based on Kampusch’s autobiography of the same name – soberly portrays her captivity in a windowless cellar less than 6 square metres (65 square feet) in area, often deprived of food for days at a time.

The emaciated Kampusch – who weighed just 38 kg (84 pounds) at one point in 2004 – keeps a diary written on toilet paper concealed in a box.

One entry reads: “At least 60 blows in the face. Ten to 15 nausea-inducing fist blows to the head. One strike with the fist with full weight to my right ear.”

The movie shows occasional moments that approach tenderness, such as when Priklopil presents her with a cake for her 18th birthday or buys her a dress as a gift – but then immediately goes on to chide her for not knowing how to waltz with him.

GREY AREAS

Antonia Campbell-Hughes, who plays the teenaged Kampusch, said she had tried to portray “the strength of someone’s soul, the ability of people to survive… but also the grey areas within a relationship that people don’t necessarily understand.”

The British actress said she had not met Kampusch during the making of the film or since. “It was a very isolated time, it was a bubble of time, and I wanted to keep that very focused,” she told journalists as she arrived for the Vienna premiere.

Kampusch herself attended the premiere, looking composed as she posed for pictures but declining to give interviews.

In an interview with Germany’s Bild Zeitung last week, she said: “Yes, I did recognize myself, although the reality was even worse. But one can’t really show that in the cinema, since it wasn’t supposed to be a horror film.”

The movie, made at the Constantin Film studios in Bavaria, Germany, also stars Amy Pidgeon as the 10-year-old Kampusch and Danish actor Thure Lindhardt as Priklopil.

“I focused mainly on playing the human being because… we have to remember it was a human being. Monsters do not exist, they’re only in cartoons,” Lindhart said.

“It became clear to me that it’s a story about survival, and it’s a story about surviving eight years of hell. If that story can be told then I can also play the bad guy.”

The director was German-American Sherry Hormann, who made her English-language debut with the 2009 move “Desert Flower”, an adaptation of the autobiography of Somali-born model and anti-female circumcision activist Waris Dirie.

“I’m a mother and I wonder at the strength of this child, and it was important for me to tell this story from a different perspective, to tell how this child using her own strength could survive this atrocious martyrdom,” Hormann said.

The Kampusch case was followed two years later by that of Josef Fritzl, an Austrian who held his daughter captive in a cellar for 24 years and fathered seven children with her.

The crimes prompted soul-searching about the Austrian psyche, and questions as to how the authorities and neighbors could have let such crimes go undetected for so long.

The film goes on general release on Thursday.

(Reporting by Georgina Prodhan, Editing by Paul Casciato)

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Global Health: After Measles Success, Rwanda to Get Rubella Vaccine

Rwanda has been so successful at fighting measles that next month it will be the first country to get donor support to move to the next stage — fighting rubella too.

On March 11, it will hold a nationwide three-day vaccination campaign with a combined measles-rubella vaccine, hoping to reach nearly five million children up to age 14. It will then integrate the dual vaccine into its national health service.

Rwanda can do so “because they’ve done such a good job on measles,” said Christine McNab, a spokeswoman for the Measles and Rubella Initiative. M.R.I. helped pay for previous vaccination campaigns in the country and the GAVI Alliance is helping to finance the upcoming one.

Rubella, also called German measles, causes a rash that is very similar to the measles rash, making it hard for health workers to tell the difference.

Rubella is generally mild, even in children, but in pregnant women, it can kill the fetus or cause serious birth defects, including blindness, deafness, mental retardation and chronic heart damage.

Ms. McNab said that Rwanda had proved that it can suppress measles and identify rubella, and it would benefit from the newer, more expensive vaccine.

The dual vaccine costs twice as much — 52 cents a dose at Unicef prices, compared with 24 cents for measles alone. (The MMR vaccine that American children get, which also contains a vaccine against mumps, costs Unicef $1.)

More than 90 percent of Rwandan children now are vaccinated twice against measles, and cases have been near zero since 2007.

The tiny country, which was convulsed by Hutu-Tutsi genocide in 1994, is now leading the way in Africa in delivering medical care to its citizens, Ms. McNab said. Three years ago, it was the first African country to introduce shots against human papilloma virus, or HPV, which causes cervical cancer.

In wealthy countries, measles kills a small number of children — usually those whose parents decline vaccination. But in poor countries, measles is a major killer of malnourished infants. Around the world, the initiative estimates, about 158,000 children die of it each year, or about 430 a day.

Every year, an estimated 112,000 children, mostly in Africa, South Asia and the Pacific islands, are born with handicaps caused by their mothers’ rubella infection.

Thanks in part to the initiative — which until last year was known just as the Measles Initiative — measles deaths among children have declined 71 percent since 2000. The initiative is a partnership of many health agencies, vaccine companies, donors and others, but is led by the American Red Cross, the United Nations Foundation, the Centers for Disease Control and Prevention, Unicef and the World Health Organization.

This article has been revised to reflect the following correction:

Correction: March 1, 2013

An article on Tuesday about a coming measles-rubella vaccination campaign in Rwanda misstated the source of the vaccine and some financing for the campaign. The vaccine and financing are being provided by the GAVI Alliance, not by the Measles and Rubella Initiative.

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Economic expansion weakest since 2011

The U.S. economy barely grew in the fourth quarter although a slightly better performance in exports and fewer imports led the government to scratch an earlier estimate that showed an economic contraction.

Gross domestic product expanded at a 0.1 percent annual rate, the Commerce Department said on Thursday, missing the 0.5 percent gain forecast by analysts in a Reuters poll.

The growth rate was the slowest since the first quarter of 2011 and far from what is needed to fuel a faster drop in the unemployment rate.

However, much of the weakness came from a slowdown in inventory accumulation and a sharp drop in military spending. These factors are expected to reverse in the first quarter.

Consumer spending was more robust by comparison, although it only expanded at a 2.1 percent annual rate.

Because household spending powers about 70 percent of national output, this still-lackluster pace of growth suggests underlying momentum in the economy was quite modest as it entered the first quarter, when significant fiscal tightening began.

Initially, the government had estimated the economy shrank at a 0.1 percent annual rate in the last three months of 2012. That had shocked economists.

Thursday's report showed the reasons for the decline were mostly as initially estimated. Inventories subtracted 1.55 percentage points from the GDP growth rate during the period, a little more of a drag than initially estimated. Defense spending plunged 22 percent, shaving 1.28 points off growth as in the previous estimate.

There were some relatively bright spots, however. Imports fell 4.5 percent during the period, which added to the overall growth rate because it was a larger drop than in the third quarter. Buying goods from foreigners bleeds money from the economy, subtracting from economic growth.

Also helping reverse the initial view of an economic contraction, exports did not fall as much during the period as the government had thought when it released its advance GDP estimate in January. Exports have been hampered by a recession in Europe, a cooling Chinese economy and storm-related port disruptions.

Excluding the volatile inventories component, GDP rose at a revised 1.7 percent rate, in line with expectations. These final sales of goods and services had been previously estimated to have increased at a 1.1 percent pace.

Business spending was revised to show more growth during the period than initially thought, adding about a percentage point to the growth rate.

Growth in home building was revised slightly higher to show a 17.5 percent annual rate. Residential construction is one of the brighter spots in the economy and is benefiting from the Federal Reserve's ultra easy monetary policy stance, which has driven mortgage rates to record lows. (Reporting by Jason Lange; Editing by Andrea Ricci)
 

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Ex-convict looks to be winner in 2nd District GOP squeaker

Republican voters are suggesting the 2nd Congressional District replace one felon with another after picking ex-convict Paul McKinley as the candidate to run for the seat recently ceded by former U.S. Rep. Jesse Jackson Jr.

While official results in the GOP special election will not be certified until next month, McKinley had a 23-vote lead over Eric Wallace, a multimedia company owner from Flossmoor, with all precincts reporting Wednesday.

McKinley, a convicted felon who served nearly 20 years in state prison for burglaries, armed robberies and aggravated battery, declared victory. Wallace, however, was not willing to concede, and he called the prospect of McKinley representing the GOP "an embarrassment."

McKinley is a frequent protester in Chicago with nearly a dozen arrests to prove it. His campaign mantra has been to rage against the machine. During candidate forums, McKinley has given passionate speeches blaming all of the district's woes on the long rule of the Democratic Party machine on the South Side and in the south suburbs.

"I was the only one in this party making the effort to rattle the saber against the machine," said McKinley, who would square off against Democrat Robin Kelly in the April 9 special election in a district that is overwhelmingly Democratic. "I think that's what resonated."

As McKinley celebrated his apparent victory, the state's Republican leadership was coming to grips with the fact that its party had just nominated someone with a long rap sheet to run in a district where the last three Democratic congressmen have left office amid scandal. That includes Jackson, who pleaded guilty last week to federal charges.

Pat Brady, the state's Republican chairman, had no comment Wednesday about McKinley's prospects. Privately, Republican leaders expressed dismay and concern. Given the historic Democratic leanings of the district, no national or state financial help from Republicans is likely, they said.

Wallace, who appears to have fallen just short for the GOP nomination, still holds out hope.

"We're waiting for all of the outstanding ballots to be tallied, including provisional as well as absentee," said Wallace, who lists a doctorate in biblical studies. "With it being this close, it wouldn't make a lot of sense not to wait for those to be counted. There could be 30, 40, 50 absentee ballots out there."

But in Cook County, there were just four such ballots. In Chicago there were three outstanding absentee or mail-in ballots and 67 provisional ballots. It's unclear how many of those provisional ballots were for the Republican primary, but very few GOP ballots were pulled in the city.

"He has that right, but he sounds a lot like Mitt Romney," McKinley said of Wallace's wait, alluding to Romney's delay in conceding victory in November to President Barack Obama.

Wallace expressed disappointment in the turnout, especially the low number of votes cast in Will and Kankakee counties, where he said many Republicans chose to cross over and vote in the Democratic primary to support Debbie Halvorson, who had opposed the president's proposed assault weapons ban.

"All they did was contribute to Robin Kelly winning, and now the Republican who is in the lead — and I've gotten to know Paul and like him — but Paul is a convicted felon," Wallace said. "If he ends up winning, it's just going to be an embarrassment for the Republican Party."

According to the Illinois Department of Corrections, McKinley was sentenced to concurrent three- and four-year sentences in 1978 for burglary and armed robbery in Cook County. In 1981 he was sentenced to four years for burglary, according to a prisons agency spokeswoman.

In 1985, McKinley was sentenced to five years for two counts of aggravated battery causing great bodily harm and 30 years for armed robbery. He was paroled in 1997, according to the state.

Two weeks ago, the Tribune asked the Cook County circuit court clerk's office to provide the old court records tied to those convictions. As of Wednesday, the records were not available. McKinley once again declined to discuss the convictions.

From 2003 through 2007, McKinley was arrested 11 times in the county for various offenses, most of them tied to protests. In many cases, the charges ultimately were dropped.

During a June 2005 bench trial, McKinley was found not guilty on two felony counts of threatening a public official. The case stemmed from a protest in which then-3rd Ward Ald. Dorothy Tillman accused McKinley of telling her to "take your country ass back to Mississippi. I'm going to get your country ass." McKinley insisted he was exercising his right to free speech and was acquitted, according to records.

In 2007, McKinley was sentenced to 20 hours of community service after being found guilty of disorderly conduct during a City Council meeting protest, records show. McKinley used a bullhorn to scream "profanity-laced statements" to aldermen as they were speaking, according a police report. Police arrested McKinley after he refused to stop banging on the glass window in the seating gallery overlooking the council chambers, records show.

McKinley also pleaded guilty to a June 2007 charge of criminal trespass to land. According to court records, he was asked to leave the Homan Square Foundation after his questions about the nonprofit's hiring procedures had been answered. The group advocates for the redevelopment of the West Side site that used to be Sears headquarters.

The candidate has not shied away from his arrest record during the campaign.

"I'm the ex-offender trying to save the next offender, and I believe Robin Kelly, she will become the next offender, too," McKinley said. "All of these next offenders in this district have been Democrats."

Kelly declined to be interviewed Wednesday.

bruthhart@tribune.com

rap30@aol.com

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New Attention to First Lady

CLINTON, Miss. — To her admirers, Michelle Obama is the patron saint of quinoa, charged with reducing the nation’s dangerous obesity rate and helping children eat better. To her detractors, she is the fun-killer, possessed with crushing America’s cookies.

But either way Mrs. Obama has taken her message once again on the road and is making clear that her campaign for healthy school lunches and fewer fat children will not be deterred.

“Now is truly the time to double down on our efforts,” she told state officials on Wednesday at an elementary school here, where she also entertained a giant group of students with a cooking contest in the cafeteria between school chefs and the celebrity food personality Rachael Ray.

Signaling that her “Let’s Move” campaign, now in its third year, will remain a central part of her own policy agenda, Mrs. Obama began a three-city tour to promote new federal school lunch policies, beginning here in Mississippi, where childhood obesity rates have fallen even as the overall rate remains the highest in the nation. “I am beyond thrilled to be back here in Mississippi,” Mrs. Obama said as lawmakers rose with their smartphones to snap photographs of her.

In 2011, the Centers for Disease Control and Prevention said that nearly 40 percent of Mississippi residents were obese. But in 2007, with the blessing of Gov. Haley Barbour, the state began to attack the problem with legislation intended to reduce fat in school lunches and to increase exercise programs.

From 2005 to 2011, obesity declined 13.3 percent among elementary school children in the state, according to the Robert Wood Johnson Foundation. Similar new federal standards for school lunches were set by the Healthy Hunger-Free Kids Act, which began in the current school year. Promoting that federal legislation, which has been relatively hard fought, is a centerpiece of Mrs. Obama’s campaign.

“Your schools did hard work, replaced their fryers with steamers, hallelujah, and started serving more fruits and vegetables and whole grains,” Mrs. Obama said. She added, “The results of these efforts speak for themselves.”

Ms. Ray, who has worked in the White House garden and championed the healthy eating of Mrs. Obama’s campaign, said that her interest in healthy food in schools stemmed from the notion that “every American needs to be concerned about the health of our nation’s kids.” The visit to the school here will be featured on her television program.

After meeting with adults, Mrs. Obama repaired to the school cafeteria for the school chef cook-off contest, where scores of children in red shirts, which matched the bowls of apples on the tables, waited for her arrival by talking, squirming and struggling to contain their excitement.

Mrs. Obama has attracted the praise of obesity experts, chefs, nutritionists and others who applaud her White House garden, her school lunch efforts and her focus on exercise, recently demonstrated in an appearance on NBC’s “Late Night With Jimmy Fallon” doing the “mom dance.” She has also found herself in the cross hairs of conservatives and other critics who see her efforts as meddlesome, frivolous or undignified.

Recently, Mrs. Obama has come under increased scrutiny after flying largely under the radar since the end of the 2012 presidential campaign. On Sunday, she announced the winner of the best picture award at the Oscars via satellite from the White House, which caused a minor national kerfuffle as some pondered the propriety of her appearance.

In The Washington Post on Wednesday, the columnist Courtland Milloy went on a full-frontal attack of both the first lady’s agenda and the attention to her appearance, which he implied she had invited. “Enough with the broccoli and Brussels sprouts,” he wrote, “to say nothing about all the attention paid to her arms, hair, derrière and designer clothes. Where is that intellectually gifted Princeton graduate, the Harvard-educated lawyer and mentor to the man who would become the first African-American president of the United States?”

Her dancing with middle school students, doing push-ups on “The Ellen DeGeneres Show,” running out for tapas with her girlfriends and clipping her locks into modern bangs both thrill and deeply annoy a nation that projects much onto its first ladies.

She will continue her tour on Thursday in Chicago, where she will announce a physical fitness initiative in schools with the tennis player Serena Williams and Education Secretary Arne Duncan. From there, Mrs. Obama will continue on to Missouri to promote adjustments in the food offerings at Walmart and discuss changes to other food businesses. She is traveling with Sam Kass, the senior policy adviser for her White House healthy food initiative.

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Groupon drops 24% on weak results, forecast

Groupon Inc., the Chicago-based daily deals website, offered up an earnings disappointment Wednesday after the market closed, and its stock price tumbled about 25 percent in after-hours trading.

The company posted a fourth-quarter net loss of $81.1 million, or 12 cents a share, missing consensus analyst estimates, which called for the company to earn 3 cents a share. Revenue for the quarter came in at $638 million, up 30 percent year-over-year and in line with estimates.

Lower margins associated with its Groupon Goods sales and higher marketing costs — taking a smaller cut from merchants to attract new business — were cited as factors contributing to the quarterly loss.

Andrew Mason, co-founder and chief executive of Groupon, pointed a finger overseas as the primary cause.

"It was continued volatility in our international business that drove the weaker-than-expected profitability in the quarter," Mason said during the earnings call Wednesday. "We still have much work to do to bring our international operations to the same level of those in North America."

The company lost $67.4 million for the year, or 10 cents a share, on revenue of $2.33 billion. Projections for first-quarter revenue between $560 million and $610 million fell below consensus estimates of $655 million. The disappointing earnings and tepid forecast sent Groupon's share price plunging from nearly $6 down to about $4.40 in after-hours trading.

Launched in 2008, Chicago-based Groupon created its own e-commerce niche with heavily discounted daily deals blasted out to subscribers via email. While targeting has become more sophisticated, growth has slowed and with it, investor enthusiasm.

The company has set out to reinvent itself, introducing search-driven deals stockpiled with ongoing offerings, and continuing to build out its own store, Groupon Goods, which sells everything from orthopedic pet beds to diamond tennis bracelets at a discount. Those initiatives have yet to make much of a dent on the bottom line.

Groupon shares hit an intraday low of $2.60 in November but rebounded after Tiger Global Management, a New York-based hedge fund, acquired a 10 percent stake in the company.

That same month, Groupon rolled out its local marketplace in Chicago and New York, a bank of thousands of ongoing deals that the company called an "evolutionary step" toward demand shopping. Customers who search online for everything from Mexican restaurants to Brazilian waxes will see relevant active deals offered by Groupon, hopefully pulling them to the site to fulfill their purchases.

While still a small part of Groupon's sales, it represents a big shift from its familiar push model, where daily deal emails fill inboxes with hit-or-miss offerings, to a pull dynamic where customers come to its sites in search of a variety of products and services.

Mason said Wednesday that the shift will ultimately pay dividends for Groupon and its investors.

"We just believe that the potential of a local marketplace business, where you can fulfill demand instead of shocking people into buy(ing) something they had no intention to buy when they woke up in the morning … it's just a much larger business opportunity," Mason said.

Analysts remain mixed about Groupon's prospects to evolve the business model beyond its core daily deals.

Edward Woo, senior research analyst at Ascendiant Capital Markets, has a "sell" rating and a $2.50 price target on the stock. He remains cautious because of slowing growth in the company's daily deals business, and he is not convinced that Groupon Goods, which accounted for $225 million in fourth-quarter revenue, is such a good idea.

"There's only a couple really big, successful e-commerce companies out there, Amazon being the biggest," Woo said Tuesday. "If you were to place your bets, do you really think that Groupon can take on Amazon? Most people would say no."

While not quite bullish, Evercore Partners analyst Ken Sena sees encouraging signs from Groupon's new searchable local marketplace and improving mobile engagement, upgrading the stock two weeks ago from "conviction sell" to "underweight," with a $5 price target, before the earnings report Wednesday.

"There are a couple of things we're encouraged by as we look at the overall story," Sena said Tuesday. "The fact that traction on mobile seems to be really strong, and growth within (their) local marketplace. I think that's an important overall business model evolution as the company moves from a push-based model to a pull-based model."

Arvind Bhatia, senior research analyst at Sterne Agee, recently upgraded Groupon to a "buy" with a $9 price target, citing the local marketplace initiative as a driver for long-term growth.

"Groupon has become synonymous with discounts," Bhatia said Tuesday. "The initial years were all about sending that email and letting you know there's a hot deal and it's going to expire soon. I don't think it's a bad thing to combine the push email with the pull."

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Winter storm: Lingering snow could mean messy commute

Tom updates Tuesday's storm. (WGN - Chicago)

The storm that struck in midmorning had socked the Chicago area with the season's biggest snowfall by Tuesday evening and was expected to drop another inch or two as it lingers through Wednesday, forecasters said.

That means the morning rush hour could be a bit messy, though it shouldn't be nearly as bad as Tuesday evening's commute was for motorists like Bob Reed, of Geneva. Speaking from a cellphone as he crawled west on Interstate 90, Reed blamed sloppy drivers more than sloppy roads.

"When it snows like this, it's like there are no traffic laws at all," Reed said. "Normally we have very aggressive drivers, but now we've got people going the wrong way down one-way streets, people jumping out of line to pass you."

The northern suburbs were hit hardest Tuesday, with Gurnee in Lake County reporting 10 inches of accumulation and Beach Park, also in Lake County, reporting 9.5 inches.

By 10 p.m., 4.2 inches had fallen at O'Hare International Airport, according to the National Weather Service. That brought the official total for the season to 17.8 inches, and February's total to 14.3 inches.

Many city and suburban schools closed early and canceled sports games and practices. By 9 p.m., more than 500 departing flights had been canceled at O'Hare and Midway airports, with about the same number of arrivals also canceled, according to FlightStats, which gathers data from airports and airlines.

Cars and buses slid into ditches and crashed into each other on slick roads. The Illinois Tollway and Chicago's Department of Streets and Sanitation dispatched their full fleets of snowplows and salt trucks.

Snow fell at about 2 inches an hour in some northern suburbs. Any snow Wednesday or the rest of the week won't be nearly that intense, said meteorologist Casey Sullivan of the National Weather Service. Leaving early for the morning commute, however, won't be a bad idea, he said.

In a winter of sparse snowfall, some welcomed the storm with enthusiasm — particularly those who stand to profit from it. James Koch, the owner of Jimbo's Plowing Service in Tinley Park, said the snow was a gift in a winter that's been a bust for plow truck drivers.

Koch bought a new truck and plow after the record snowfall during the 2011 Groundhog Day blizzard. Since then he has failed to realize the returns he expected on his investment, he said.

"It ain't like what it used to be," Koch said. "Chicago always had a good snowfall, and now we're not getting snow until January. If you don't get a big snow in December in this business, you're basically playing catch-up all year."

The snow also gave fresh life to plans for winter recreation. Gloria Morison, of Highland Park, was at a brunch Tuesday morning when she saw the first flakes fall. She said she immediately started making plans to try out a new pair of cross country skis, thinking she could go down her street before the plows came to get to the Green Bay Trail.

Chicago Transit Authority buses had a hard time navigating some roads Tuesday. A few buses got stuck near North Stockton Drive and West Dickens Avenue, police said.

"Obviously, we're advising operators to drive with caution," CTA spokeswoman Lambrini Lukidis said.

With snow forecast to fall periodically Wednesday and Thursday, drivers should continue to heed that advice, said Sullivan of the weather service. Even after the storm passes there could be more in store, with unrelated lake-effect snow possible Friday, he said.

"We'll see."

Tribune reporters Ryan Haggerty and Naomi Nix contributed.

ehirst@tribune.com

jhuston@tribune.com

agrimm@tribune.com

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Advanced Breast Cancer May Be Rising Among Young Women, Study Finds

The incidence of advanced breast cancer among younger women, ages 25 to 39, may have increased slightly over the last three decades, according to a study released Tuesday.

But more research is needed to verify the finding, which was based on an analysis of statistics, the study’s authors said. They do not know what may have caused the apparent increase.

Some outside experts questioned whether the increase was real, and expressed concerns that the report would frighten women needlessly.

The study, published in The Journal of the American Medical Association, found that advanced cases climbed to 2.9 per 100,000 younger women in 2009, from 1.53 per 100,000 women in 1976 — an increase of 1.37 cases per 100,000 women in 34 years. The totals were about 250 such cases per year in the mid-1970s, and more than 800 per year in 2009.

Though small, the increase was statistically significant, and the researchers said it was worrisome because it involved cancer that had already spread to organs like the liver or lungs by the time it was diagnosed, which greatly diminishes the odds of survival.

For now, the only advice the researchers can offer to young women is to see a doctor quickly if they notice lumps, pain or other changes in the breast, and not to assume that they cannot have breast cancer because they are young and healthy, or have no family history of the disease.

“Breast cancer can and does occur in younger women,” said Dr. Rebecca H. Johnson, the first author of the study and medical director of the adolescent and young adult oncology program at Seattle Children’s Hospital.

But Dr. Johnson noted that there is no evidence that screening helps younger women who have an average risk for the disease and no symptoms. “We’re certainly not advocating that young women get mammography at an earlier age than is generally specified,” she said.

Expert groups differ about when screening should begin; some say at age 40, others 50.

Breast cancer is not common in younger women; only 1.8 percent of all cases are diagnosed in women from 20 to 34, and 10 percent in women from 35 to 44. However, when it does occur, the disease tends to be more deadly in younger women than in older ones. Researchers are not sure why.

The researchers analyzed data from SEER, a program run by the National Cancer Institute to collect cancer statistics on 28 percent of the population of the United States. The study also used data from the past when SEER was smaller.

The study is based on information from 936,497 women who had breast cancer from 1976 to 2009. Of those, 53,502 were 25 to 39 years old, including 3,438 who had advanced breast cancer, also called metastatic or distant disease.

Younger women were the only ones in whom metastatic disease seemed to have increased, the researchers found.

Dr. Archie Bleyer, a clinical research professor in radiation medicine at the Knight Cancer Institute at the Oregon Health and Science University in Portland who helped write the study, said scientists needed to verify the increase in advanced breast cancer in young women in the United States and find out whether it is occurring in other developed Western countries. “This is the first report of this kind,” he said, adding that researchers had already asked colleagues in Canada to analyze data there.

“We need this to be sure ourselves about this potentially concerning, almost alarming trend,” Dr. Bleyer said. “Then and only then are we really worried about what is the cause, because we’ve got to be sure it’s real.”

Dr. Johnson said her own experience led her to look into the statistics on the disease in young women. She had breast cancer when she was 27; she is now 44. Over the years, friends and colleagues often referred young women with the disease to her for advice.

“It just struck me how many of those people there were,” she said.

Dr. Donald A. Berry, an expert on breast cancer data and a professor of biostatistics at the University of Texas’ M. D. Anderson Cancer Center in Houston, said he was dubious about the finding, even though it was statistically significant, because the size of the apparent increase was so small — 1.37 cases per 100,000 women, over the course of 30 years.

More screening and more precise tests to identify the stage of cancer at the time of diagnosis might account for the increase, he said.

“Not many women aged 25 to 39 get screened, but some do, but it only takes a few to account for a notable increase from one in 100,000,” Dr. Berry said.

Dr. Silvia C. Formenti, a breast cancer expert and the chairwoman of radiation oncology at New York University Langone Medical Center, questioned the study in part because although it found an increased incidence of advanced disease, it did not find the accompanying increase in deaths that would be expected.

A spokeswoman for an advocacy group for young women with breast cancer, Young Survival Coalition, said the organization also wondered whether improved diagnostic and staging tests might explain all or part of the increase.

“We’re looking at this data with caution,” said the spokeswoman, Michelle Esser. “We don’t want to invite panic or alarm.”

She said it was important to note that the findings applied only to women who had metastatic disease at the time of diagnosis, and did not imply that women who already had early-stage cancer faced an increased risk of advanced disease.

Dr. J. Leonard Lichtenfeld
, deputy chief medical officer of the American Cancer Society, said he and an epidemiologist for the society thought the increase was real.

“We want to make sure this is not oversold or that people suddenly get very frightened that we have a huge problem,” Dr. Lichtenfeld said. “We don’t. But we are concerned that over time, we might have a more serious problem than we have today.”

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What's next for revitalized Chicago Loop?

Michael Edwards has only been in town for a few months, but the new executive director of the Chicago Loop Alliance says the warm reception he's getting makes him feel part of something distinctly Chicago.

There's the strong handshake upon meeting. Direct eye contact. A hearty "Welcome to Chicago," he notes. "It's really a dynamic thing," Edwards says with a laugh. "I get it all the time."

A Buffalo, N.Y., native who took the role in November, Edwards arrived at a crucial time for the alliance, which is charged with representing downtown businesses and promoting the area as a destination to live, work and play. On the rebound from the Great Recession, the Loop is aiming to solidify its place as a hub for businesses, retail and residents — from college students to urban professionals to empty nesters who seek easy access to transportation, Millennium Park and museums.

But the return hasn't been easy. During the economic downturn, vacancies shot up, but a rash of new apartments are under construction in downtown Chicago. Target Corp. filled the long-empty Carson Pirie Scott & Co. storefront with its new urban format on State Street in July, and a few blocks up The Gap will open a new store in the spring. State Street's crown jewel, Block 37, is still trying to land a big tenant to drive more foot traffic to the mall.

Now that vacancies are declining and rents are climbing, Edwards and other civic leaders are aiming to figure out what's next for the business district and State Street retail corridor.

At its annual meeting Tuesday, Edwards and the Chicago Loop Alliance announced development of a five-year strategic plan aimed at clarifying the organization's role in economic development, housing, transportation, tourism, culture and services in the Loop. It's the first ever in the organization's history.

The process will tap input from business owners, elected officials, civic leaders and alliance board members, said Edwards, who held similar positions in Pittsburgh and Spokane, Wash. He replaced executive director Ty Tabing, who left in the summer to head up an economic development organization in Singapore.

The strategic planning process is under way, and a draft is due in June. Oakland, Calif.- based MIG Inc. was hired to assist in developing the new strategy.

With the Loop moving in the right direction, it's time to shift gears and ask residents and business owners what they think of its opportunities and challenges, as well as the role of the alliance, Edwards says.

The need for a new plan is driven in part by Edwards' arrival, but also by the fact that the State Street special service area, one of 44 local tax districts that fund expanded services and programs with a property tax levy, is up for renewal in 2016. The State Street SSA collects about $2.5 million annually.

Part of the planning process will include determining whether the SSA, which is administered by the Chicago Loop Alliance and pays for such services as public way maintenance and district marketing, security and economic development, should be expanded to encompass all of the Loop's business and retail districts, including Dearborn Street and Wabash Avenue as well as North Michigan Avenue, he said.

No decisions have been yet, Edwards said. "We're pretty focused on State Street, but can we provide that level of service to other areas?" he said.

Edwards said the new strategy will also determine whether the alliance, which has an annual budget of about $3.4 million, should take on a larger role as an advocate for the Loop.

"We have a website that's all about our members that gets about 10,000 hits a year, and we need about 2 million hits a year. And we need to control the narrative about what's going on downtown," he said.

With other local organizations such as Choose Chicago and World Business Chicago tasked with touting the region, "Is there a role for us to amplify this notion that we're an authentic American city that's an economic engine for the region?" asked Edwards. "Is there a role for the CLA to help promote that or not?"

If the new focus of the alliance has yet to be determined, Edwards has few opinions. Any new partnerships with other local groups, he said, will have to be formed "organically."

And he predicts the alliance's focus will likely shift to "typical downtown management duties — keeping the area safe and clean," coupled with "a little more economic development sensibility as opposed to an arts sensibility," he said.

For years, the Chicago Loop Alliance has run the PopUp Art Loop program in which public art was showcased in vacant storefronts. But the number of empty retail spaces along State Street has been cut in half, to about six, Edwards said.

Now that State Street has evolved, it's time the alliance's role evolved too, according to officials.

"We're seeing a lot of tremendous opportunities for growth in the Loop, whether it's in retail, new companies coming downtown, new residents or tourism," said Martin Stern, executive vice president and managing director at US Equities Realty and board chairman of the Chicago Loop Alliance.

Added Edwards: "There's a sort of feeling that we need to be more focused, provide more value, provide more leadership."

crshropshire@tribune.com

Twitter @corilyns

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Blackhawks win in overtime, extend streak to 19

Nikolai Khabibulin stumbled coming out of the tunnel from the Oilers' dressing room to start the second period before steadying himself on the bench and taking the ice.

Then the Oilers goaltender was tripped up by the Blackhawks, and the longest streak in NHL history to start a season without a regulation loss lives on at 19.

Marian Hossa scored the winner in overtime to lift the Hawks to a 3-2 victory over the Oilers on Monday night at the United Center. Patrick Kane and Viktor Stalberg had goals in regulation and Ray Emery earned the win in goal as the Hawks improved to 16-0-3 this season. Dating to last season, they have gone 25 consecutive games with at least one point.

Jeff Petry and Nail Yakupov scored for the Oilers, who kicked off a 17-day, nine-game trip with the loss.

The Oilers came out with the speed and determination they displayed last season against the Hawks when they won three of four games with a 24-15 goal advantage. Emery was tested early but came up big when he dropped to his pads to smother an attempt from the slot by Ales Hemsky.

A delay-of-game penalty on Magnus Paajarvi for flipping the puck into the stands produced offense from both sides. Edmonton got on the board while short-handed as Lennart Petrell raced into the Hawks' zone on a breakaway after defenseman Duncan Keith fell down. Emery made a strong save on Petrell's attempt, but the rebound was ripe for the picking and Petry fired it into the open net.

With time running out in the penalty, the Hawks displayed the resiliency that has been a key to their points streak as Kane worked his way into the slot and slid a backhander past Khabibulin for his 10th goal of the season and a 1-1 tie.

Later in the first, Emery kept it even when he stoned Corey Potter from in close with the Oilers on the power play.

In the second, Daniel Carcillo, who was the most physical player on the ice for both sides with booming hits throughout the game, had a chance offensively from the slot but couldn't solve Khabibulin.

Brandon Saad's second penalty of the game for the Hawks led to the Oilers' second goal. Edmonton moved the puck nicely and Sam Gagner hit an open Yakupov with a pass and the rookie unloaded a one-timer past Emery.

Stalberg pulled the Hawks even early in the third when he stuffed a shot under the pad of Khabibulin from the crease. A video review confirmed the puck crossed the line and the score was 2-2.

The close game was nothing new to the Hawks, who entered the game with a 9-0-3 mark in one-goal games.

"The whole league is close," coach Joel Quenneville said. "When you aren't playing … you're watching and it's a one-goal night and you're hoping it's not a three-point game. Everybody keeps themselves in games."

ckuc@tribune.com

Twitter @ChrisKuc

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