raise awareness
Consciousness raising (also called awareness raising) is a form of activism popularized by United States feminists in the late 1960s. It often takes the form of a group of people attempting to focus the attention of a wider group on some cause or ...
breast cancer
Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, milk rejection, fluid coming from the nipple, a newly inverted nipple, or ...
through education on symptoms and treatment. Supporters hope that greater knowledge will lead to earlier detection of breast cancer, which is associated with higher long-term survival rates, and that money raised for breast cancer will produce a reliable, permanent cure.
Breast cancer advocacy and awareness efforts are a type of
health advocacy
Health advocacy or health activism encompasses direct service to the individual or family as well as activities that promote health and access to health care in communities and the larger public. Advocates support and promote the rights of the pa ...
lobby
Lobby may refer to:
* Lobby (room), an entranceway or foyer in a building
* Lobbying, the action or the group used to influence a viewpoint to politicians
:* Lobbying in the United States, specific to the United States
* Lobby (food), a thick st ...
for better care, more knowledge, and more
patient empowerment
Patient participation is a trend that arose in answer to medical paternalism. Informed consent is a process where patients make decisions informed by the advice of medical professionals.
In recent years, the term "patient participation" has been ...
. They may conduct educational campaigns or provide free or low-cost services. Breast cancer culture, sometimes called pink ribbon culture, is the cultural outgrowth of breast cancer advocacy, the
social movement
A social movement is a loosely organized effort by a large group of people to achieve a particular goal, typically a social or political one. This may be to carry out a social change, or to resist or undo one. It is a type of group action and ma ...
that supports it, and the larger
women's health
Women's health differs from that of men in many unique ways. Women's health is an example of population health, where health is defined by the World Health Organization as "a state of complete physical, mental and social well-being and not mer ...
movement.
The
pink ribbon
The pink ribbon is an international symbol of breast cancer awareness. Pink ribbons, and the color pink in general, identify the wearer or promoter with the breast cancer brand and express moral support for women with breast cancer. Pink ribb ...
is the most prominent symbol of breast cancer awareness, and in many countries, the month of October is
National Breast Cancer Awareness Month
Breast Cancer Awareness Month (BCAM), also referred to in the United States as National Breast Cancer Awareness Month (NBCAM), is an annual international health campaign organized by major breast cancer charities every October to increase awaren ...
. Some national breast cancer organizations receive substantial financial support from
corporate sponsorship
Sponsoring something (or someone) is the act of supporting an event, activity, person, or organization financially or through the provision of products or services. The individual or group that provides the support, similar to a benefactor, is k ...
conflicts of interest
A conflict of interest (COI) is a situation in which a person or organization is involved in multiple interests, financial or otherwise, and serving one interest could involve working against another. Typically, this relates to situations i ...
The goal of breast cancer awareness campaigns is to raise the public's "
brand awareness
Brand awareness is the extent to which customers are able to recall or recognize a brand under different conditions. Brand awareness is one of two dimensions from brand knowledge, an associative network memory model. Brand awareness is a key consi ...
" for breast cancer, its detection, its treatment, and the need for a reliable, permanent cure. Increased awareness has increased the number of women receiving mammograms, the number of breast cancers detected, and the number of women receiving biopsies. Overall, as a result of awareness, breast cancers are being detected at an earlier, more treatable stage. Awareness efforts have successfully utilized marketing approaches to reduce the stigma associated with the disease.
Generally speaking, breast cancer awareness campaigns have been highly effective in getting attention for the disease. Breast cancer receives significantly more media coverage than other prevalent cancers, such as
prostate cancer
Prostate cancer is cancer of the prostate. Prostate cancer is the second most common cancerous tumor worldwide and is the fifth leading cause of cancer-related mortality among men. The prostate is a gland in the male reproductive system that sur ...
.
Breast cancer as a brand
Breast cancer advocacy uses the
pink ribbon
The pink ribbon is an international symbol of breast cancer awareness. Pink ribbons, and the color pink in general, identify the wearer or promoter with the breast cancer brand and express moral support for women with breast cancer. Pink ribb ...
and the color
pink
Pink is the color of a namesake flower that is a pale tint of red. It was first used as a color name in the late 17th century. According to surveys in Europe and the United States, pink is the color most often associated with charm, politeness, ...
as a
concept brand
A brand is a name, term, design, symbol or any other feature that distinguishes one seller's good or service from those of other sellers. Brands are used in business, marketing, and advertising for recognition and, importantly, to create a ...
to raise money and increase screening. The breast cancer brand is strong: people who support the "pink brand" are members of the socially aware
niche market
A niche market is the subset of the market on which a specific product is focused. The market niche defines the product features aimed at satisfying specific market needs, as well as the price range, production quality and the demographics that it ...
, who are in favor of improved lives for women, believe in positive thinking, trust biomedical science to be able to solve any problem if given enough money, and prefer curative treatments to prevention.
The brand ties together fear of cancer, hope for early identification and successful treatment, and the moral goodness of women with breast cancer and anyone who visibly identifies themselves with breast cancer patients. This brand permits and even encourages people to substitute
conscientious consumption
Ethical consumerism (alternatively called ethical consumption, ethical purchasing, moral purchasing, ethical sourcing, or ethical shopping and also associated with sustainable and green consumerism) is a type of consumer activism based on the conc ...
and individual
symbolic action
A symbol is a mark, sign, or word that indicates, signifies, or is understood as representing an idea, object, or relationship. Symbols allow people to go beyond what is known or seen by creating linkages between otherwise very different conc ...
s, like buying or wearing a pink ribbon, for concrete, practical results, such as collective political action aimed at discovering non-genetic causes of breast cancer.
The establishment of the brand and the entrenchment of the breast cancer movement has been uniquely successful, because no
countermovement
A countermovement in sociology means a social movement opposed to another social movement. Whenever one social movement starts up, another group establishes themselves to undermine the previous group. Many social movements start out as an effect ...
opposes the breast cancer movement or believes that breast cancer is desirable.
Pink ribbon
A pink ribbon is a symbol of breast cancer awareness. It may be worn to honor those who have been diagnosed with breast cancer, or to identify products that a manufacturer would like to sell to consumers that are interested in breast cancer. Pink ribbons are sometimes sold as fundraisers, much like poppies on Remembrance Day.
The pink ribbon is associated with individual generosity, faith in scientific progress, and an optimistic "can-do" attitude. It encourages individuals to focus on the emotionally appealing ultimate vision of a cure for breast cancer, rather than the reality that there is no certain cure for breast cancer, and no guarantee there will ever be such a cure. The practice of blindly wearing or displaying a pink ribbon without making other, more concrete efforts to cure breast cancer has been described as a kind of
slacktivism
Slacktivism (a portmanteau of ''slacker'' and ''activism'') is the practice of supporting a political or social cause by means such as social media or online petitions, characterized as involving very little effort or commitment. Additional form ...
due to its lack of real effects, and has been compared to equally simple yet ineffective "awareness" practices like the drive for women to post the colors of their bras on
Facebook
Facebook is an online social media and social networking service owned by American company Meta Platforms. Founded in 2004 by Mark Zuckerberg with fellow Harvard College students and roommates Eduardo Saverin, Andrew McCollum, Dustin M ...
. Critics say that the feel-good nature of pink ribbons and "pink consumption" distracts society from the lack of progress in curing breast cancer. It is also criticized for reinforcing gender stereotypes and
objectifying
In social philosophy, objectification is the act of treating a person, as an object or a thing. It is part of dehumanization, the act of disavowing the humanity of others. Sexual objectification, the act of treating a person as a mere object of sex ...
women and their breasts.
Events
Each year, the month of October is recognized as
Breast Cancer Awareness Month
Breast Cancer Awareness Month (BCAM), also referred to in the United States as National Breast Cancer Awareness Month (NBCAM), is an annual international health campaign organized by major breast cancer charities every October to increase awaren ...
by many governments, the media, and
cancer survivors
A cancer survivor is a person with cancer of any type who is still living. Whether a person becomes a survivor at the time of diagnosis or after completing treatment, whether people who are actively dying are considered survivors, and whether ...
. The month-long campaign has been called ''Pinktober'' because of the increased production of pink goods for sale, and ''National Breast Cancer Industry Month'' by critics like
Breast Cancer Action
Breast Cancer Action (BCAction) is a U.S.-based grassroots education and activist organization driven by and supporting people living with breast cancer. It was founded in 1990 by Elenore Pred, Susan Claymon, and Linda Reyes. Based in San Franci ...
. BCAM was begun in 1985 by the
American Cancer Society
The American Cancer Society (ACS) is a nationwide voluntary health organization dedicated to eliminating cancer. Established in 1913, the society is organized into six geographical regions of both medical and lay volunteers operating in more than ...
and pharmaceutical company
AstraZeneca
AstraZeneca plc () is a British-Swedish multinational pharmaceutical and biotechnology company with its headquarters at the Cambridge Biomedical Campus in Cambridge, England. It has a portfolio of products for major diseases in areas includin ...
. The organization that runs the official BCAM aims to promote
mammography
Mammography (also called mastography) is the process of using low-energy X-rays (usually around 30 kVp) to examine the human breast for diagnosis and screening. The goal of mammography is the early detection of breast cancer, typically through d ...
and other forms of early detection as the most effective means of fighting breast cancer.
Typical BCAM events include fundraising-based
foot race
Running is a method of terrestrial locomotion allowing humans and other animals to move rapidly on foot. Running is a type of gait characterized by an aerial phase in which all feet are above the ground (though there are exceptions). This is ...
s,
walk-a-thons
A walkathon (walk-a-thon), walking marathon or sponsored walk is a type of community or school fundraiser in which participants raise money by collecting donations or pledges for walking a predetermined distance or course. They are similar in for ...
, and bicycle rides. Participants solicit donations to a breast cancer-related charity in return for running, walking, or riding in the event. Through mass-participation events, breast cancer survivors form a single, united group that speaks and acts consistently and shares a coherent set of beliefs. They also reinforce the cultural connection between each individual's
physical fitness
Physical fitness is a state of health and well-being and, more specifically, the ability to perform aspects of Outline of sports, sports, occupations and daily activities. Physical fitness is generally achieved through proper nutrition, moderate ...
and moral fitness. Events organized by Avon or Komen are known to allocate around 25%-33% of donations to the funds needed to organize the event and advertise it.
Various
landmark
A landmark is a recognizable natural or artificial feature used for navigation, a feature that stands out from its near environment and is often visible from long distances.
In modern use, the term can also be applied to smaller structures or f ...
s are illuminated in pink lights as a visible reminder of breast cancer, and public events, such as American football games, may use pink equipment or supplies. In 2010, all
King Features Syndicate
King Features Syndicate, Inc. is a American content distribution and animation studio, consumer product licensing and print syndication company owned by Hearst Communications that distributes about 150 comic strips, newspaper columns, editoria ...
comic strips on one Sunday were printed in shades of red and pink, with a pink ribbon logo appearing prominently in one panel.
Private companies may arrange a "pink day", in which employees wear pink clothes in support of breast cancer patients, or pay for the privilege of a relaxed
dress code
A dress code is a set of rules, often written, with regard to what clothing groups of people must wear. Dress codes are created out of social perceptions and norms, and vary based on purpose, circumstances, and occasions. Different societies an ...
, such as
Lee National Denim Day
Lee National Denim Day is a fundraiser created by Lee Jeans to support the women's cancer programs of the Entertainment Industry Foundation. Every year, people are asked to donate the money they would spend on a pair of jeans to support breast ca ...
. Some events are directed at people in specific communities, such as the
Global Pink Hijab Day
Global Pink Hijab Day was an initiative that began as an experiment by founder, Hend El-Buri and a group of high school students in Columbia, Missouri. It was intended to remove stereotypes of Islam, Muslim women by having Muslims engage in dial ...
, which was started in America to encourage appropriate medical care and reduce the stigma of breast cancer among Muslim women, and Male Breast Cancer Awareness Week, which some organizations highlight during the third week of October. Most events are well-received, but some, like the unauthorized painting of the Pink Bridge in
Huntington, West Virginia
Huntington is a city in Cabell and Wayne counties in the U.S. state of West Virginia. It is the county seat of Cabell County, and the largest city in the Huntington–Ashland metropolitan area, sometimes referred to as the Tri-State Area. A h ...
, are controversial.
Many
cancer survivor
A cancer survivor is a person with cancer of any type who is still living. Whether a person becomes a survivor at the time of diagnosis or after completing treatment, whether people who are actively dying are considered survivors, and whether ...
s find that BCAM is an emotionally difficult time, as it reminds them of a
distressing
Distressing (or weathered look) in the decorative arts is the activity of making a piece of furniture or object appear aged and older, giving it a "weathered look". There are many methods to produce an appearance of age and wear. Distressing is ...
time and because the cheerful marketing images do not match their experiences.
Companies and consumers
Thousands of breast cancer-themed products are developed and sold each year. Some of these items are everyday products that have been repackaged or repositioned to take advantage of
cause-related marketing
Cause marketing is marketing done by a for-profit business that seeks to both increase profits and to better society in accordance with corporate social responsibility, such as by including activist messages in advertising.
A similar phrase, ca ...
, such as teddy bears, clothing, jewelry, candles, and coffee mugs. These blended value objects offer consumers an opportunity to simultaneously buy an object and make a donation to a breast cancer organization. Some of these products are produced and/or sold by breast cancer survivors or charities for fundraising purposes, while others are for profits in addition to fundraising. Manufacturers also produce products with pink labels or pink ribbon logos to donate a sum of money to support the cause. The donation is typically capped so that it is reached after a fixed level of sales, although in some cases the company is providing only free advertising for a selected charity. Although advertising costs are rarely disclosed, some companies have been found to spend far more money advertising "pink products" and tie-ins than they donate to charitable organizations supporting research or patients. For example, in 2005, 3M spent US$500,000 advertising
post-it
A Post-it Note (or sticky note) is a small piece of paper with a re-adherable strip of glue on its back, made for temporarily attaching notes to documents and other surfaces. A low-tack pressure-sensitive adhesive allows the notes to be easil ...
notes printed with a pink ribbon logo. Sales were nearly double what the company expected, but the campaign resulted in a $300,000 donation.
Advertisers and retail consultants have said that because of consumer cynicism, a company can benefit from marketing its support for a cause such as breast cancer awareness only when the company treats that support as "a commitment and not a marketing opportunity". Andrew Benett, an executive at
Euro RSCG
Havas Creative, formerly known as Havas Worldwide and Euro RSCG, is a French advertising agency. It is one of the largest integrated marketing communications agencies in the world, made up of 316 offices located in 75 countries. The firm provid ...
said that because consumers "have become more mindful, more thoughtful, about how they consume, where they consume, why they consume", companies cannot succeed by "just slapping a pink ribbon on a product and xpecting thatpeople will buy more". Pink products have also been condemned as promoting
consumerism
Consumerism is a social and economic order that encourages the acquisition of goods and services in ever-increasing amounts. With the Industrial Revolution, but particularly in the 20th century, mass production led to overproduction—the supp ...
,
materialism
Materialism is a form of philosophical monism which holds matter to be the fundamental substance in nature, and all things, including mental states and consciousness, are results of material interactions. According to philosophical materiali ...
, and environmental degradation. Critics are also concerned that the ubiquity of pink products may mislead people into thinking that significant progress has been made, and that small, individual actions, like buying a breast cancer-themed product, are sufficient. Responding to criticism, Komen CEO
Nancy G. Brinker
Nancy Goodman Brinker (born December 6, 1946) is the founder of The Promise Fund and Susan G. Komen for the Cure, an organization named after her only sister, who died from breast cancer. Brinker was also United States Ambassador to Hungary from ...
said that corporate promotions enabled the organization to reach new audiences and that "America is built on consumerism. To say we shouldn't use it to solve the social ills that confront us doesn't make sense to me".
The first breast cancer awareness stamp in the U.S., featuring a pink ribbon, was issued in 1996. As it did not sell well, a
semi-postal
A semi-postal stamp or semipostal stamp, also known as a charity stamp, is a postage stamp issued to raise money for a particular purpose (such as a charitable cause) and sold at a premium over the postal value. Typically the stamp shows two deno ...
stamp without a pink ribbon, the
breast cancer research stamp
The breast cancer research stamp (BCRS) is a semi-postal non-denominated postage stamp issued by the United States Postal Service, priced in 2011 as eleven cents higher than the standard first-class letter rate. The surplus above the price of th ...
, was designed in 1998. Products like these emphasize the relationship between being a consumer and supporting women with breast cancer. In Canada, the Royal Canadian Mint produced 30 million 25-cent coins with pink ribbons during 2006 for normal circulation. Designed by the mint's director of engraving, Cosme Saffioti (reverse), and Susanna Blunt (obverse), this colored coin is the second in history to be put into regular circulation.
Business marketing campaigns, particularly sales promotions for products that increase pollution or have been linked to the development of breast cancer, such as alcohol, high-fat foods, some pesticides, or the
parabens
Parabens are a class of widely used preservatives in cosmetic and pharmaceutical products. Chemically, they are a series of parahydroxybenzoates or esters of parahydroxybenzoic acid (also known as 4-hydroxybenzoic acid). Parabens are effective ...
and
phthalates
Phthalates (, ), or phthalate esters, are esters of phthalic acid. They are mainly used as plasticizers, i.e., substances added to plastics to increase their flexibility, transparency, durability, and longevity. They are used primarily to soften ...
used by most cosmetic companies, have been condemned as pinkwashing (a
portmanteau
A portmanteau word, or portmanteau (, ) is a blend of words''whitewash''). Such promotions generally result in a token donation to a breast cancer-related charity by taking advantage of the consumers' fear of cancer and grief for people who have died to drive sales. Critics say that these promotions, which net more than US$30 million each year just for fundraising powerhouse
Susan G. Komen for the Cure
Susan G. Komen (formerly known as Susan G. Komen for the Cure; originally as The Susan G. Komen Breast Cancer Foundation; often simply as Komen) is a breast cancer organization in the United States.
Komen focuses on patient navigation and advo ...
, do little more than support the marketing machines that produce them. Komen says that corporate sponsorships are necessary to pay for the organization's efforts: in the 2010
fiscal year
A fiscal year (or financial year, or sometimes budget year) is used in government accounting, which varies between countries, and for budget purposes. It is also used for financial reporting by businesses and other organizations. Laws in many ...
it spent $175 million on public health education and awareness campaigns, $75 million on medical research and about $67 million on treatment and screenings for patients.
Two significant campaigns against pink consumption are the
National Breast Cancer Coalition
The National Breast Cancer Coalition (NBCC) is a grassroots advocacy organization that combines the power of advocacy, education, policy, and research to unite around the goal of ending breast cancer.
It was founded in 1991 by a group of breast ...
's "Not Just Ribbons" campaign, and Breast Cancer Action's "Think Before You Pink" campaign. NBCC's "Not Just Ribbons" campaign sought to focus awareness efforts onto substantive issues such as
genetic discrimination
Genetic discrimination occurs when people treat others (or are treated) differently because they have or are perceived to have a gene mutation(s) that causes or increases the risk of an inherited disorder. It may also refer to any and all discri ...
, access to cancer treatment,
patient rights
A patient's bill of rights is a list of guarantees for those receiving medical care. It may take the form of a law or a non-binding declaration. Typically a patient's bill of rights guarantees patients information, fair treatment, and autonomy ov ...
, and environmental breast cancer research. "Think Before You Pink" encouraged consumers to ask questions about pink products (e.g., to find out how much of a donation was being made).
Advertisements
Many corporate and charitable organizations run advertisements related to breast cancer, especially during National Breast Cancer Awareness Month, in the hope of increasing sales by aligning themselves with a positive, helpful message. In addition to selling pink products, corporate advertisements may promote the company's progressive policies, or may provide free advertising for a chosen charity. Medical institutions may run advertisements for
mammogram
Mammography (also called mastography) is the process of using low-energy X-rays (usually around 30 kVp) to examine the human breast for diagnosis and screening. The goal of mammography is the early detection of breast cancer, typically through d ...
or other breast-related services. Non-profit organizations often benefit from
public service announcement
A public service announcement (PSA) is a message in the public interest disseminated by the media without charge to raise public awareness and change behavior. In the UK, they are generally called a public information film (PIF); in Hong Kong, ...
s, which are free advertisements provided by newspapers, radio and television stations, and other media. Some marketing blurs the line between advertisements and events, such as
flash mob
A flash mob (or flashmob) is a group of people who assemble suddenly in a public place, perform for a brief time, then quickly disperse, often for the purposes of entertainment, satire, and artistic expression. Flash mobs may be organized via t ...
s as a form of
guerrilla marketing
Guerrilla marketing is an advertisement strategy in which a company uses surprise and/or unconventional interactions in order to promote a product or service. It is a type of publicity. The term was popularized by Jay Conrad Levinson's 198 ...
. The typical participant in the breast cancer movement, and therefore the advertisers'
target audience
A target audience is the intended audience or readership of a publication, advertisement, or other message catered specifically to said intended audience. In marketing and advertising, it is a particular group of consumer within the predetermined ...
, is a white, middle-aged, middle-class, well-educated woman.
Some corporate sponsors are criticized for having a
conflict of interest
A conflict of interest (COI) is a situation in which a person or organization is involved in multiple interests, financial or otherwise, and serving one interest could involve working against another. Typically, this relates to situations i ...
. For example, some of the prominent sponsors of these advertisements include businesses that sell the expensive equipment needed to perform screening mammography; an increase in the number of women seeking mammograms means an increase in their sales, which has led critics to say that their sponsorship is not a voluntary act of charity, but an effort to increase sales. The regulated drug and medical device industry uses the color pink, positive images, and other themes of the pink ribbon culture in
direct-to-consumer advertising
Direct-to-consumer advertising (DTCA) refers to the marketing and advertising of pharmaceutical products directly to consumers as patients, as opposed to specifically targeting health professionals. The term is synonymous primarily with the ad ...
to associate their breast cancer products with the fear, hope, and wholesome goodness of the breast cancer movement. This is particularly evident in advertisements designed to sell screening mammograms.
Social role of the woman with breast cancer
The marketing of breast cancer awareness allows people to incorporate support for awareness into their
personal identity
Personal identity is the unique numerical identity of a person over time. Discussions regarding personal identity typically aim to determine the necessary and sufficient conditions under which a person at one time and a person at another time can ...
or
lifestyle
Lifestyle often refers to:
* Lifestyle (sociology), the way a person lives
* ''Otium'', ancient Roman concept of a lifestyle
* Style of life (german: Lebensstil, link=no), dealing with the dynamics of personality
Lifestyle may also refer to:
Bu ...
. Socially aware, pro-woman individuals, businesses, politicians, and organizations use pink ribbons and other trappings of breast cancer awareness to signal their support for women, health, and mainstream medicine.
The she-ro
The term ''she-ro'', derived from
hero
A hero (feminine: heroine) is a real person or a main fictional character who, in the face of danger, combats adversity through feats of ingenuity, courage, or Physical strength, strength. Like other formerly gender-specific terms (like ...
, is used in discussions of breast cancer to refer to women who have been diagnosed with breast cancer, and sometimes to those who have survived breast cancer. The term describes an "idealized" patient who combines assertiveness, optimism, femininity and sexuality, despite the effects of treatment, and as a "paragon houses a diagnosis of breast cancer as a catalyst for a personal transformation".
Sociologist Gayle Sulik analyzed the she-ro's
social role
A role (also rôle or social role) is a set of connected behaviors, rights, obligations, beliefs, and norms as conceptualized by people in a social situation. It is an expected or free or continuously changing behavior and may have a given indivi ...
and ascribes it qualities that include being an educated medical
consumer
A consumer is a person or a group who intends to order, or uses purchased goods, products, or services primarily for personal, social, family, household and similar needs, who is not directly related to entrepreneurial or business activities. T ...
with a brave, pleasant and
optimistic
Optimism is an attitude reflecting a belief or hope that the outcome of some specific endeavor, or outcomes in general, will be positive, favorable, and desirable. A common idiom used to illustrate optimism versus pessimism is a glass filled wi ...
public appearance and demeanor, who aggressively fights breast cancer through compliance with screening guidelines and "disciplined practice of 'breast health'". In
America
The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territorie ...
the she-ro is diagnosed early due to adherence to early
screening
Screening may refer to:
* Screening cultures, a type a medical test that is done to find an infection
* Screening (economics), a strategy of combating adverse selection (includes sorting resumes to select employees)
* Screening (environmental), a ...
recommendations, and, by definition, she survives her diagnosis and treatment. The role emphasizes the
femininity
Femininity (also called womanliness) is a set of attributes, behaviors, and roles generally associated with women and girls. Femininity can be understood as socially constructed, and there is also some evidence that some behaviors considered fe ...
and female
gender role
A gender role, also known as a sex role, is a social role encompassing a range of behaviors and attitudes that are generally considered acceptable, appropriate, or desirable for a person based on that person's sex. Gender roles are usually cent ...
of the she-ro, offsetting the
masculine
Masculinity (also called manhood or manliness) is a set of attributes, behaviors, and roles associated with men and boys. Masculinity can be theoretically understood as socially constructed, and there is also evidence that some behaviors con ...
characteristics of assertiveness, selfishness and "fighting" cancer by cultivating a feminine appearance and concern for others. During and after treatment, the she-ro regains her femininity by using breast reconstruction, prosthetic devices, wigs, cosmetics, and clothing to present an aesthetically appealing, upper-class, heterosexual feminine appearance and by maintaining relationships in which she can nurture other people. Following the proper
feeling rules Feeling rules are socially shared norms that influence how people want to try to feel emotions in given social relations. This concept was introduced by sociologist Arlie Russell Hochschild in 1979. Hochschild's 1983 book, '' The Managed Heart: Com ...
of the breast cancer culture is encouraged, including remaining optimistic of a full cure, rationalizing the selfishness of treatment as a temporary measure, and feeling guilty that it forces her to put her needs momentarily above the needs of others or due to her perceived inadequacy in caring for her family or other women with cancer. Also included in the role is a form of the have-it-all
superwoman
Superwoman is the name of several fictional characters from DC Comics. Most of them are, like Supergirl, women with powers similar to those of Superman, like flight, invulnerability, and enhanced strength. Detective Comics, Inc. trademarked the ...
, cultivating a normal appearance and activity level and minimizing the disruption that breast cancer causes to people around her.
Consequences
The effort of maintaining the role of a she-ro can be stressful. The role encourages women with breast cancer to care for others rather than themselves. Some of them find this comforting, but it may lead to them feeling reluctant or unable to ask for the help they need or want, and this can lead to bitterness that their friends and family did not offer these services unbidden. The success of their efforts to look and act normally may paradoxically increase their dissatisfaction, as their apparent ability to handle it all discourages people from offering help.
The breast cancer culture celebrates women who display the attitude deemed correct, which implies that their continued survival is due to this positive attitude and fighting spirit. While cheerfulness, hope, and good social support can be advantageous to health outcomes, it cannot determine survival rates. Women who reject the she-ro model may find themselves socially isolated by the breast cancer
support group
In a support group, members provide each other with various types of help, usually nonprofessional and nonmaterial, for a particular shared, usually burdensome, characteristic. Members with the same issues can come together for sharing coping str ...
s that are nominally supposed to help them. Support from "the sisterhood" favors the "passionately pink", and tends to overlook women whose response to being diagnosed with breast cancer is incompatible with the pink ribbon culture, because they feel angry, unhappy, or afraid.
The breast cancer culture is ill-equipped to deal with women who are dying or who have died, and their experiences may not be memorialized, validated or represented as part of the movement, instead being ignored or shunned as failures and as hope-destroying examples of reality. They may feel like treatment failure is a "dirty little secret" that others want to make invisible. Similarly, the culture is also ill-equipped to deal with the news that a previously hyped treatment or screening procedure has been determined to be ineffective, with women advocating for the acceptance and promotion of inexpedient activities and inefficient or even sometimes harmful drugs.
Breast cancer culture
Breast cancer culture, or pink ribbon culture, is the set of activities, attitudes, and values that surround and shape breast cancer in public. The dominant values are selflessness, cheerfulness, unity, and optimism. It is pro-doctor, pro-medicine, and pro-mammogram. Health care professionals are sources of information, but the rightness of their advice is not to be seriously questioned by women with breast cancer. Patients are not encouraged to ask where research money is going or if the research industry is making progress in finding the "cure". The emphasis on cheerfulness allows society to blame women for developing breast cancer and limits their responses to certain culturally determined scripts. The requirement of cheerful optimism arose from the then-popular theory that cancer had a
psychosomatic
A somatic symptom disorder, formerly known as a somatoform disorder,(2013) Psychotherapy
Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome pro ...
was therefore considered an adjunct treatment used to produce a cheerful, self-affirming identity. This theory was predominant among psychiatrists through the 1970s, but has since been discredited. In a process called benefit finding, the she-ro uses the emotional trauma of being diagnosed with breast cancer and the suffering of extended treatment to transform herself into a stronger, happier and more sensitive person who is grateful for the opportunity to become a better person. In particular, she sees breast cancer as an opportunity to give herself permission for necessary personal growth that she felt she was prohibited from or unable to make before. Breast cancer thereby becomes a
rite of passage
A rite of passage is a ceremony or ritual of the passage which occurs when an individual leaves one group to enter another. It involves a significant change of status in society. In cultural anthropology the term is the Anglicisation of ''rite ...
rather than a disease, with pink ribbon culture honoring the suffering of its she-roes by selecting them based on the amount of misery they have experienced, and leading women whose treatment is less painful or debilitating to feel excluded and devalued. The suffering, particularly the extended suffering of months of chemotherapy and radiation treatment, forms a
metaphor
A metaphor is a figure of speech that, for rhetorical effect, directly refers to one thing by mentioning another. It may provide (or obscure) clarity or identify hidden similarities between two different ideas. Metaphors are often compared wit ...
ical type of ordeal or rite of passage that initiates women into the inner circle of breast cancer culture.
Barbara Ehrenreich
Barbara Ehrenreich (, ; ; August 26, 1941 – September 1, 2022) was an American author and political activist. During the 1980s and early 1990s, she was a prominent figure in the Democratic Socialists of America. She was a widely read and awar ...
describes it this way:
Understood as a rite of passage, breast cancer resembles the initiation rites so exhaustively studied by Mircea Eliade: First there is the selection of the initiates—by age in the tribal situation, by mammogram or palpation here. Then come the requisite ordeals—scarification or circumcision within traditional cultures, surgery and chemotherapy for the cancer patient. Finally, the initiate emerges into a new and higher status—an adult and a warrior—or in the case of breast cancer, a "survivor".
Mainstream pink ribbon culture has aspects that are trivializing, silencing, and infantilizing. Women with breast cancer are surrounded by childish kitsch such as pink teddy bears and crayons, but there is no equivalent gift of toy cars for men diagnosed with
prostate cancer
Prostate cancer is cancer of the prostate. Prostate cancer is the second most common cancerous tumor worldwide and is the fifth leading cause of cancer-related mortality among men. The prostate is a gland in the male reproductive system that sur ...
. Women who choose not to conform to the culture may feel excluded and isolated; those who cannot conform to the prescribed triumphant script report feeling unable to share their stories honestly. Anger, negativity and fatalism transgress the feeling rules, and women with breast cancer who express anger or negativity are corrected by other women with breast cancer and members of the breast cancer support organizations. Appearing unattractive—such as going out in public with a bare, bald head if treatment causes temporary hair loss—transgresses the approved, upper-class style of pink femininity and provokes shaming comments from strangers. Programs such as Reach to Recovery and Look Good, Feel Better inform breast cancer patients of this cultural standard and help them conform to it. This standard is not universally adhered to in every detail. Ehrenreich says that " e question of wigs versus baldness ... defines one of the few real disagreements in breast-cancer culture." Some women have ''
avant garde
The avant-garde (; In 'advance guard' or 'vanguard', literally 'fore-guard') is a person or work that is experimental, radical, or unorthodox with respect to art, culture, or society.John Picchione, The New Avant-garde in Italy: Theoretical De ...
'' aesthetic tastes: "One decorates her scalp with
temporary tattoo
A tattoo is a form of body modification made by inserting tattoo ink, dyes, and/or pigments, either indelible or temporary, into the dermis layer of the skin to form a design. Tattoo artists create these designs using several tattooing pr ...
s of peace signs, panthers, and frogs; another expresses herself with a shocking purple wig; a third reports that unadorned baldness makes her feel 'sensual, powerful, able to recreate myself with every new day'". Regardless of whether the transformation is towards a radical, natural or cosmetically enhanced appearance, treatment is always "a
makeover
A makeover is a radical change in appearance. When the word is used to describe a change in human physical appearance, it may imply a change in clothing, haircut, or cosmetics. A personal makeover might also include weight loss, plastic surgery, ...
opportunity".
Since the beginning of the 21st century, breast cancer culture has become more sexualized, and many awareness campaigns now reflect the old advertising truism that sex sells. The "booby campaigns", such as "Save the Tatas" and the "I ♥ Boobies" gel bracelets, rely on a cultural obsession with breasts and a market that is already highly aware of breast cancer. This message trivializes women and reflects a belief that breast cancer is important because cancer and its treatment makes women feel less sexually desirable and interferes with men's sexual access to women's breasts, instead of because cancer and its treatment kill and disable women. These sexualized campaigns tend to attract a younger audience than traditional campaigns.
At the same time, breast cancer culture tends to overlook men with breast cancer and women who do not fit the white, middle-class archetype.
African-American
African Americans (also referred to as Black Americans and Afro-Americans) are an Race and ethnicity in the United States, ethnic group consisting of Americans with partial or total ancestry from sub-Saharan Africa. The term "African American ...
s involved with breast cancer organizations often feel like their role is to be the token minority.
The primary purposes or goals of the breast cancer culture itself are to maintain breast cancer's dominance as the preëminent women's health issue, to promote the appearance that society is "doing something" effective about breast cancer, and to sustain and expand the social, political, and financial power of breast cancer
activist
Activism (or Advocacy) consists of efforts to promote, impede, direct or intervene in social, political, economic or environmental reform with the desire to make changes in society toward a perceived greater good. Forms of activism range fro ...
s.
The breast cancer culture tells women with breast cancer that their participation in fundraising, social support of other women with breast cancer, and appearance at public events are critical activities that promote their own emotional recovery. Because of this message, some women begin to believe that refusing to raise money for breast cancer organizations or to become mentors for newly diagnosed women with breast cancer is an unhealthy response to breast cancer.
Feminism and the breast cancer wars
The breast cancer wars were a series of conflicts between advocates and others about the causes, treatments, and societal responses to breast cancer. Women in the late 1980s and 1990s followed the successful approach used by ACT-UP and other AIDS awareness groups, of staging media-friendly protests to increase political pressure. Prominent women who made the "wrong" choice were publicly excoriated, as when
Nancy Reagan
Nancy Davis Reagan (; born Anne Frances Robbins; July 6, 1921 – March 6, 2016) was an American film actress and First Lady of the United States from 1981 to 1989. She was the second wife of president Ronald Reagan.
Reagan was born in N ...
chose mastectomy over lumpectomy followed by six weeks of
radiation therapy
Radiation therapy or radiotherapy, often abbreviated RT, RTx, or XRT, is a therapy using ionizing radiation, generally provided as part of cancer treatment to control or kill malignant cells and normally delivered by a linear accelerator. Radia ...
. The
abortion–breast cancer hypothesis
The abortion–breast cancer hypothesis posits that having an induced abortion can increase the risk of getting breast cancer. This hypothesis is at odds with mainstream scientific opinion and is rejected by major medical professional organizatio ...
was formulated when an early study showed a connection between voluntary
abortion
Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of pregn ...
s and the development of breast cancer in premenopausal women, which pitted breast cancer advocates against abortion rights advocates.
Advocates for women's issues have said that breast cancer is special because of its status as a largely female disease, society's response to it is an ongoing indication of the status of women and the existence of
sexism
Sexism is prejudice or discrimination based on one's sex or gender. Sexism can affect anyone, but it primarily affects women and girls.There is a clear and broad consensus among academic scholars in multiple fields that sexism refers primari ...
. Breast cancer activist Virginia Soffa wrote that " long as it is not a national priority, the breast cancer epidemic will remain a metaphor for how society treats women". Barbara Ehrenreich writes that, before the feminist movement "medicine was a solid patriarchy", and women with breast cancer were often treated as passive, dependent objects, incapable of making appropriate choices, whose role was to accept whatever treatment was decreed by the physicians and surgeons, who held all of the power. Because of sexism in education, female surgeons were far outnumbered by their male counterparts, and until the 1990s, when
Susan Love
Susan M. Love (born February 9, 1948) is an American surgeon, a prominent advocate of preventive breast cancer research, and author. She is regarded as one of the most respected women’s health specialists in the United States. In 2012 Love an ...
of the
University of California, Los Angeles
The University of California, Los Angeles (UCLA) is a public land-grant research university in Los Angeles, California. UCLA's academic roots were established in 1881 as a teachers college then known as the southern branch of the California St ...
Breast Center published ''Dr. Susan Love's Breast Book'', the physicians who provided breast cancer treatments were generally men. Love said that some male physicians tended to impose their own values on women, such as recommending mastectomy to older women because, being past the age of child bearing and breastfeeding, they no longer "needed" their breasts. The
women's health movement
The presence of women in medicine, particularly in the practicing fields of surgery and as physicians, has been traced to the earliest of history. Women have historically had lower participation levels in medical fields compared to men with occ ...
promoted mutual aid, self-help, networking, and an active, informed role in the patient's health care. Since the end of the breast cancer wars, feminists have again objected to the breast cancer culture's treatment of women with breast cancer as little girls who need to be obedient to authority figures, cooperative, pleasant and pretty.
Achievements of the breast cancer movement
Social progress
Breast cancer has been known to educated women and caregivers throughout history, but modesty and horror at the consequences of a largely untreatable disease made it a
taboo
A taboo or tabu is a social group's ban, prohibition, or avoidance of something (usually an utterance or behavior) based on the group's sense that it is excessively repulsive, sacred, or allowed only for certain persons.''Encyclopædia Britannica ...
subject. The breast cancer movement, which developed in the 1980s and 1990s out of 20th century
feminist movements
The feminist movement (also known as the women's movement, or feminism) refers to a series of social movements and political campaigns for radical and liberal reforms on women's issues created by the inequality between men and women. Such i ...
and the women's health movement, has mostly removed those taboos through its modern advocacy and awareness campaigns.
Educated, empowered patients
At the beginning and middle of the 20th century, breast cancer was usually discussed in hushed tones, as if it were shameful. As an example, ''
The New York Times
''The New York Times'' (''the Times'', ''NYT'', or the Gray Lady) is a daily newspaper based in New York City with a worldwide readership reported in 2020 to comprise a declining 840,000 paid print subscribers, and a growing 6 million paid ...
'' refused to publish an advertisement for a breast cancer support group in the early 1950s, stating that it would not print either the word ''breast'' or the word ''cancer''. Later, however, several celebrities publicly disclosed their own health challenges, and the resulting publicity reduced the stigma. One of the first was
Shirley Temple Black
Shirley Temple Black (born Shirley Jane Temple;While Temple occasionally used "Jane" as a middle name, her birth certificate reads "Shirley Temple". Her birth certificate was altered to prolong her babyhood shortly after she signed with Fox in ...
, the former child star, who announced her diagnosis in 1972. In October 1974,
Betty Ford
Elizabeth Anne Ford (; formerly Warren; April 8, 1918 – July 8, 2011) was the first lady of the United States from 1974 to 1977, as the wife of President Gerald Ford. As first lady, she was active in social policy and set a precedent as a pol ...
, the wife of the then-President of the United States, openly discussed her breast cancer diagnosis and mastectomy. Two weeks later, the wife of the then-Vice President also had a mastectomy for breast cancer. The next year, journalist Rose Kushner published her book, ''Breast Cancer: A Personal History and Investigative Report'', which she had written while recovering from a
modified radical mastectomy
Mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. A mastectomy is usually carried out to treat breast cancer. In some cases, women believed to be at high risk of breast cancer have the operat ...
. More recently, Angelina Jolie has also come forward publicly regarding her experience surrounding her diagnosis and treatment, which managed to raise public awareness of the issue significantly. In one study, when a survey of women was taken following Jolie's announcement, awareness rose by 4% among those women surveyed. The media reported these women's health and their treatment choices, and even invited some to appear on
talk show
A talk show (or chat show in British English) is a television programming or radio programming genre structured around the act of spontaneous conversation.Bernard M. Timberg, Robert J. Erler'' (2010Television Talk: A History of the TV Talk Show ...
s to discuss breast cancer frankly.
The breast cancer movement has resulted in widespread acceptance of
second opinion
A second opinion is an opinion on a matter disputed by two or more parties.
Law
In legal cases, a second opinion which contradicts the opinion of a jointly retained expert may be disregarded as not being impartial.
Consumer rights
In cas ...
s, the development of less invasive surgical procedures, the spread of
support group
In a support group, members provide each other with various types of help, usually nonprofessional and nonmaterial, for a particular shared, usually burdensome, characteristic. Members with the same issues can come together for sharing coping str ...
s, and other advances in patient care. The movement successfully separated diagnostic biopsy from mastectomy surgery; before about 1980, it was common to perform the biopsy and, if a quick review of tissues indicated a probable need, a mastectomy in the same surgery. The one-step surgery prevented women from seeking different opinions about their treatment, and sent them into the surgery without knowing whether their breasts would be removed that day. In response to women's concerns over
lymphedema
Lymphedema, also known as lymphoedema and lymphatic edema, is a condition of localized swelling caused by a compromised lymphatic system. The lymphatic system functions as a critical portion of the body's immune system and returns interstitial fl ...
after routine removal of
lymph nodes
A lymph node, or lymph gland, is a kidney-shaped organ of the lymphatic system and the adaptive immune system. A large number of lymph nodes are linked throughout the body by the lymphatic vessels. They are major sites of lymphocytes that includ ...
during mastectomy, the more limited approach of sentinel node biopsy was developed. Advocacy efforts also led to the formal recommendation against the routine use of the Halsted radical mastectomy in favor of simple mastectomies and lumpectomies.
The breast cancer movement has supported practical, educational, emotional, and financial care for women with breast cancer. Support groups, individual counseling opportunities, and other resources are made available to patients.
Educational interventions using written material and brief one-to-one interaction about breast checking behaviour, breast cancer symptoms and age-related risk have the potential to increase breast cancer awareness in older women, over a sustained period of time.
Increased resources for treatment and research
Supporting breast cancer was seen as a distinctively pro-woman stance popular among public official. This has resulted in better access to care. For example, in much of the United States, low-income women with breast cancer may qualify for taxpayer-funded health care benefits, such as screening mammography, biopsies, or treatment, while women with the same income, but another form of cancer or a medical condition other than cancer, do not.As an example, the
State of Texas
Texas (, ; Spanish: ''Texas'', ''Tejas'') is a state in the South Central region of the United States. At 268,596 square miles (695,662 km2), and with more than 29.1 million residents in 2020, it is the second-largest U.S. state by ...
hypertension
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...
,
diabetes mellitus
Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ap ...
, or
lung cancer
Lung cancer, also known as lung carcinoma (since about 98–99% of all lung cancers are carcinomas), is a malignant lung tumor characterized by uncontrolled cell growth in tissue (biology), tissues of the lung. Lung carcinomas derive from tran ...
, the incom limit is 185% of FPIG
Breast cancer advocates have successfully increased the amount of public money being spent on cancer research and shifted the research focus away from other diseases and towards breast cancer. Breast cancer advocates also raise millions of dollars for research into cures each year, although most of the funds they raise is spent on screening programs, education and treatment. Most breast cancer research is funded by government agencies.
The high level of awareness and organized political lobbying has resulted in a disproportionate level of funding and resources given to breast cancer research and care. Favoring breast cancer with disproportionate research may have the
unintended consequence
In the social sciences, unintended consequences (sometimes unanticipated consequences or unforeseen consequences) are outcomes of a purposeful action that are not intended or foreseen. The term was popularised in the twentieth century by Ameri ...
of costing lives elsewhere. In 2001 UK MP Ian Gibson said, "The treatment has been skewed by the lobbying, there is no doubt about that. Breast cancer sufferers get better treatment in terms of bed spaces, facilities and doctors and nurses".
Risks of over-awareness
Awareness has also led to increased anxiety for women. Early detection efforts result in overdiagnosis of precancerous and cancerous tumors that would never risk the woman's life (about one-third of breast cancers diagnosed through screening programs), and result in her being subjected to invasive and sometimes dangerous radiological and surgical procedures.
In recent years, the definition of breast cancer has expanded to include non-invasive, non-cancerous conditions like
lobular carcinoma in situ
Lobular carcinoma ''in situ'' (LCIS) is an incidental microscopic finding with characteristic cellular morphology and multifocal tissue patterns. The condition is a laboratory diagnosis and refers to unusual cells in the lobules of the breast. T ...
(LCIS) and pre-cancerous or "stage 0" conditions like
ductal carcinoma in situ
Ductal carcinoma in situ (DCIS), also known as intraductal carcinoma, is a pre-cancerous or non-invasive cancerous lesion of the breast. DCIS is classified as Stage 0. It rarely produces symptoms or a breast lump one can feel, typically being d ...
(DCIS). Despite the now-regretted decision to use the word ''carcinoma'' in these relatively common conditions (almost a quarter of "breast cancer" diagnoses in the USA), they are not life-threatening
cancer
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
s. Women with these conditions are promoted as breast cancer survivors due to the fear they experienced before they became educated about their condition, rather than in respect of any real threat to their lives. This effectively increases the
market size
In economics, a market is a composition of systems, institutions, procedures, social relations or infrastructures whereby parties engage in exchange. While parties may exchange goods and services by barter, most markets rely on sellers offering ...
for breast cancer organizations, medical establishments, pharmaceutical manufacturers, and the makers of mammography equipment.
Women fear dying from breast cancer more than dying from
heart disease
Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, hea ...
, even though, as of 2006, eleven times as many women died from heart disease and stroke as from breast cancer. According to cardiologist Lisa Rosenbaum, this may be because women "view heart disease as the consequence of having done something bad, whereas to get breast cancer is to have something bad happen to you".
An emphasis on educating women about lifestyle changes that may have a small impact on preventing breast cancer often makes women feel guilty if they do develop breast cancer. Some women decide that their own cancer resulted from poor diet, lack of exercise, or other modifiable lifestyle factor, even though most cases of breast cancer are due to non-controllable factors, like genetics or naturally occurring background radiation. Adopting such a belief may increase their sense of being in control of their fate. Increased awareness inadvertently increases
victim blaming
Victim blaming occurs when the victim of a crime or any wrongful act is held entirely or partially at fault for the harm that befell them. There is historical and current prejudice against the victims of domestic violence and sex crimes, such as ...
. Women who resist screening mammography or breast self-exams are subjected to social pressure, scare tactics, guilt, and threats from some physicians to terminate the relationship with the patient. Similarly, the emphasis on early detection results in many women wrongly blaming themselves if their cancer is not detected at an early stage.
The promotion of research to make screening programs find ever more cancers is also criticized. One-third of diagnosed breast cancers might recede on their own. In addition to efficiently finding most deadly cancers, screening programs also find most non-life-threatening, asymptomatic breast cancers and pre-cancers, and miss some fast growing, aggressive, dangerous cancers. According to H. Gilbert Welch of the Dartmouth Institute for Health Policy and Clinical Practice, "I'm certainly not asking anyone to stop getting mammograms. I am asking my profession to tell women the truth about
overdiagnosis
Overdiagnosis is the diagnosis of disease that will never cause symptoms or death during a patient's ordinarily expected lifetime and thus presents no practical threat regardless of being pathologic. Overdiagnosis is a side effect of screening fo ...
". Welch said that research on screening mammography has taken the "brain-dead approach that says the best test is the one that finds the most cancers" rather than the one that finds dangerous cancers.
Clinicians have responded that they are unwilling to consider the possibility of leaving potential deadly cancers alone because it is "far-riskier" than the alternative. Eric Winer, director of the breast cancer program at Dana-Farber Cancer Institute in Boston, says, "I don't know anyone who offers women the option of doing nothing". Further complicating the issue of early diagnosis is the fact that it is currently impossible to distinguish malicious cancers from benign ones. Otis Brawley, a top official for the American Cancer Society, says that "even if we overdiagnose 1 in 5, we have numerous studies showing that by treating all these women, we save a bunch of lives". For instance, a 2011 Cochrane review showed a sample of mammogram screening programs resulted in a 15% reduction in mortality rate despite over-diagnosis, indicating that mammography programs save lives regardless of over-diagnosis.
Conflicts of interest in organizations
Some critics say that breast cancer awareness has transformed the disease into a market-driven industry of survivorship and corporate sales pitches. Corporate marketing machines promote early detection of breast cancer, while also opposing public health efforts, such as stricter environmental legislation, that might decrease the incidence rate of breast cancer. These critics believe that some of the breast cancer organizations, particularly the highly visible Susan G. Komen for the Cure, have become captive companies that support and provide
social capital
Social capital is "the networks of relationships among people who live and work in a particular society, enabling that society to function effectively". It involves the effective functioning of social groups through interpersonal relationships ...
to the breast cancer industry, including
pharmaceutical companies
The pharmaceutical industry discovers, develops, produces, and markets drugs or pharmaceutical drugs for use as medications to be administered to patients (or self-administered), with the aim to cure them, vaccinate them, or alleviate symptoms. ...
, mammography equipment manufacturers, and pollution-causing industries, as well as large corporations, creating or exacerbating other problems.
For example,
Ford Motor Company
Ford Motor Company (commonly known as Ford) is an American multinational automobile manufacturer headquartered in Dearborn, Michigan, United States. It was founded by Henry Ford and incorporated on June 16, 1903. The company sells automobi ...
ran a "Warriors in Pink" promotion on their
Ford Mustang
The Ford Mustang is a series of American automobiles manufactured by Ford. In continuous production since 1964, the Mustang is currently the longest-produced Ford car nameplate. Currently in its sixth generation, it is the fifth-best selli ...
sports car, which critics say was intended to sell cars and counter the bad publicity the company received by reducing its workforce by tens of thousands of people, causing many of them to lose their
health insurance
Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among ma ...
, rather than to prevent or cure breast cancer. A Ford spokesperson acknowledged that the objective of the promotion was to "do good works throughout the community and derive some marketing exposure at the same time", but said that over the promotion's 15 years the company had donated $100 million and that the company continued the program during the
automotive industry crisis of 2008–2010
The automotive industry crisis of 2008–2010 formed part of the financial crisis of 2007–2008 and the resulting Great Recession. The crisis affected European and Asian automobile manufacturers, but it was primarily felt in the American automob ...
because "It's part of our DNA now." Ford believes that the recipient of the funds, Susan G. Komen for the Cure, benefited because Ford helped it reach "people who might not have thought of this organization before or may be supporting other organizations".
However, the primary sponsors are part of the breast cancer industry, particularly cancer drug makers like AstraZeneca, Bristol-Myers Squibb, and Novartis. Because the national breast cancer organizations are dependent on
corporate sponsorship
Sponsoring something (or someone) is the act of supporting an event, activity, person, or organization financially or through the provision of products or services. The individual or group that provides the support, similar to a benefactor, is k ...
s for survival, this situation may represent a conflict of interest that prevents these organizations from representing the needs of current and future people with breast cancer when those needs conflict with the profit-making motives of the corporate sponsors.
The structure of the breast cancer movement may allow large organizations to claim to be the voice of women with breast cancer, while simultaneously ignoring their desires.
Some breast cancer organizations, such as Breast Cancer Action, refuse to accept funds from medical or other companies they disapprove of.
Environmental breast cancer movement
Most of the money raised by advocates is spent on increasing awareness,
cancer screening
Cancer screening aims to detect cancer before symptoms appear. This may involve blood tests, urine tests, DNA tests, other tests, or medical imaging. The benefits of screening in terms of cancer prevention, early detection and subsequent treatme ...
, and existing treatments. Only a small fraction of the funds is spent on research, and less than 7% of the total research funding provided by breast cancer organizations goes to prevention. Instead, most of the charities fund research into detection and treatment. Advocates like Breast Cancer Action and women's health issues scholar Samantha King, whose book inspired the 2011 documentary ''
Pink Ribbons, Inc.
''Pink Ribbons, Inc.'' is a 2011 National Film Board of Canada (NFB) documentary about the pink ribbon campaign, directed by Léa Pool and produced by Ravida Din. The film is based on the 2006 book ''Pink Ribbons, Inc: Breast Cancer and the Politi ...
'', are unhappy that relatively little money or attention is devoted to identifying the non-genetic causes of breast cancer or to preventing breast cancer from occurring. The mainstream breast cancer culture has been criticized for focusing on detecting and curing existing breast cancer cases, rather than on preventing future cases.
As a result, screening mammography is promoted by the breast cancer culture as the sole possible approach to
public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the det ...
for breast cancer. Alternatives, such as pollution prevention, are largely ignored.
As the majority of women with breast cancer have no risk factors other than sex and age, the environmental breast cancer movement suspects pollution as a significant cause, possibly from pesticides, plastics, and industrial runoff in ground water. Large organizations, such as Susan G. Komen for the Cure and the American Cancer Society, are not part of the environmental breast cancer movement. These large organizations benefit the most from corporate sponsorships that critics deride as ''pinkwashing'', e.g., polluting industries trying to buy public goodwill by publishing advertisements emblazoned with pink ribbons, rather than stopping their pollution under the
precautionary principle
The precautionary principle (or precautionary approach) is a broad epistemological, philosophical and legal approach to innovations with potential for causing harm when extensive scientific knowledge on the matter is lacking. It emphasizes caut ...
.
The non-genetic factors with consistent evidence increasing breast cancer risk include "
ionizing radiation
Ionizing radiation (or ionising radiation), including nuclear radiation, consists of subatomic particles or electromagnetic waves that have sufficient energy to ionize atoms or molecules by detaching electrons from them. Some particles can travel ...
, combination
estrogen–progestin hormone therapy
Hormone replacement therapy (HRT), also known as menopausal hormone therapy or postmenopausal hormone therapy, is a form of hormone therapy used to treat symptoms associated with female menopause. These symptoms can include hot flashes, vaginal ...
, and greater postmenopausal weight. ... for many other factors, the evidence from human studies is more limited, contradictory, or absent" and called for additional research. Conducting research into whether a chemical causes cancer is difficult, because "suspect chemicals cannot ethically be given to people to see if they cause cancer. People exposed in the past can be studied, but information about the dose and timing may be sketchy. Animal studies can provide useful information, but do not always apply to humans. And people are often exposed to mixtures of chemicals that may interact in complex ways, with effects that may also vary depending on an individual's genetic makeup".
Samantha King says that prevention research is minimized by the breast cancer industry because there is no way to make money off of cases of breast cancer that do not happen, whereas a mammography imaging system that finds more possible cancers, or a "magic bullet" that kills confirmed cancers, would be highly profitable.
Breast Cancer Action
Breast Cancer Action is an American
grassroots
A grassroots movement is one that uses the people in a given district, region or community as the basis for a political or economic movement. Grassroots movements and organizations use collective action from the local level to effect change at t ...
education and
advocacy
Advocacy is an Action (philosophy), activity by an individual or advocacy group, group that aims to influence decision making, decisions within political, economic, and social institutions. Advocacy includes activities and publications to infl ...
organization that promotes breast cancer awareness and
public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the det ...
issues relating to breast cancer, and advocates for system-wide change based on prevention. Breast Cancer Action is also known for its ''Think Before You Pink'' campaign, launched in 2002, which encourages consumers to ask critical questions before buying
pink ribbon
The pink ribbon is an international symbol of breast cancer awareness. Pink ribbons, and the color pink in general, identify the wearer or promoter with the breast cancer brand and express moral support for women with breast cancer. Pink ribb ...
products.
Dissent through art
While the pink ribbon culture is dominant, there are alternatives. The environmental breast cancer movement is one type of dissent. Another is the rejection of compliant optimism, aesthetic normalization, and social pleasingness that the pink ribbon culture promotes.
In 1998, the Art.Rage.Us art collective published a book that collected some of the art work from their traveling collection. This included art that was shocking, painful and realistic rather than beautiful, such as several self-portraits that showed mastectomy scars.
Another art form has a wider range: the illness narrative has become a staple of breast cancer literature and is prominent in women's magazines. This may take the form of a restitution or cure narrative (the protagonist seeks a physical or spiritual return to a pre-diagnosis life), a quest narrative (the protagonist must meet a goal before dying), or a chaos narrative (the situation inexorably goes from bad to worse). The cure and quest narratives fit neatly with the breast cancer culture. Chaos narratives, which are rarer in stories about breast cancer, oppose it.
History
Breast cancer has been known since ancient times. With no reliable treatments, and with surgical outcomes often fatal, women tended to conceal the possibility of breast cancer as long as possible. With the dramatic improvement in survival rates at the end of the 19th century—the radical mastectomy promoted by William Stewart Halsted raised long-term survival rates from 10% to 50%—efforts to educate women about the importance of early detection and prompt action were begun.
Early campaigns included the "Women's Field Army", run by the American Society for the Control of Cancer (the forerunner of the American Cancer Society) during the 1930s and 1940s. Explicitly using a military metaphor, they promoted early detection and prompt medical intervention as every woman's duty in the war on cancer. In 1952, the first peer-to-peer support group, called Reach to Recovery, was formed. Later taken over by the American Cancer Society, it provided post-mastectomy, in-hospital visits from women who had survived breast cancer, who shared their own experiences, practical advice, and emotional support, but never medical information. This was the first program designed to promote restoration of a feminine appearance, e.g., through providing
breast prostheses
Breast prostheses are breast forms intended to look like breasts. They are often used temporarily or permanently by women after mastectomy or lumpectomy procedures, but may also be used by for aesthetic purposes. There are a number of materials an ...
, as a goal.
Organizations
A wide variety of charitable organizations are involved in breast cancer awareness and support. These organizations do everything from providing practical support, to educating the public, to dispensing millions of dollars for research and treatment. Thousands of small breast cancer organizations exist. The largest and most prominent are:
*
Susan G. Komen for the Cure
Susan G. Komen (formerly known as Susan G. Komen for the Cure; originally as The Susan G. Komen Breast Cancer Foundation; often simply as Komen) is a breast cancer organization in the United States.
Komen focuses on patient navigation and advo ...
: Komen is the largest and best funded organization, with highly visible fundraisers.
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National Breast Cancer Coalition
The National Breast Cancer Coalition (NBCC) is a grassroots advocacy organization that combines the power of advocacy, education, policy, and research to unite around the goal of ending breast cancer.
It was founded in 1991 by a group of breast ...
: This large umbrella organization played key roles in several prominent pieces of American legislation, such as the creation of the
United States Department of Defense
The United States Department of Defense (DoD, USDOD or DOD) is an executive branch department of the federal government charged with coordinating and supervising all agencies and functions of the government directly related to national secu ...
's Breast Cancer Research Program, genetic non-discrimination laws, and the patients' bill of rights. They are committed to
evidence-based medicine
Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients". The aim of EBM is to integrate the experience of the clinician, the values of t ...
.
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Breast Cancer Action
Breast Cancer Action (BCAction) is a U.S.-based grassroots education and activist organization driven by and supporting people living with breast cancer. It was founded in 1990 by Elenore Pred, Susan Claymon, and Linda Reyes. Based in San Franci ...
: Famous for its "Think Before You Pink" campaign against pinkwashing, BCA emphasizes the need for research into pollution as a cause of breast cancer. Like the
National Women's Health Network
The National Women's Health Network (NWHN) is a non-profit women's health advocacy organization located in Washington, D.C. It was founded in 1975 by Barbara Seaman, Alice Wolfson, Belita Cowan, Mary Howell, and Phyllis Chesler. The stated missi ...
, they refuse funding from any group that may have a
conflict of interest
A conflict of interest (COI) is a situation in which a person or organization is involved in multiple interests, financial or otherwise, and serving one interest could involve working against another. Typically, this relates to situations i ...
, such as pharmaceutical companies, medical imaging companies, or pollution-causing industries.
* National Breast Cancer Organization: Closed in 2004. A dissenter to the notion of mandatory public unity, it provided case management and other services.
See also
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List of awareness ribbons
This is a partial list of awareness ribbons. The meaning behind an awareness ribbon depends on its colors and pattern. Since many advocacy groups have adopted ribbons as symbols of support or awareness, ribbons, particularly those of a single col ...
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List of health-related charity fundraisers
This list of health related charity fundraisers includes events designed to raise funds to fight disease and improve health.
Bike rides
Climbs
Runs
Note that all runs allow jogging and walking.
*Race for the Cure, Team Heather (2003-Cur ...
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Male breast cancer
Male breast cancer (MBC) is a cancer in males that originates in their breasts. Males account for less than 1% of new breast cancers with about 20,000 new cases being diagnosed
worldwide every year. Its incidence rates in males vs. females are, ...