Could “breast cancer awareness” be deeper?

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By Gayle A. Sulik, PhD, MA, author of Pink Ribbon Blues

For more than two decades, Breast Cancer Action has diligently challenged the cancer industry and the breast cancer advocacy movement at large to address the root causes of the breast cancer epidemic and to ask critical questions about where the money goes, how it is raised, and what it accomplishes. As incidence rates of the disease continue to rise and the majority of breast cancers come from unknown causes, it is clear that common awareness messages about genes, lifestyles, mammograms, and the promise of cutting-edge research are not solving the breast cancer problem – despite the billions of dollars raised and spent each year in the name of the cause. BCAction has been on the forefront of asking why?

Unfortunately, the answer to that question is just as complicated as the question itself. First, cancer is multifactorial (i.e., stemming from multiple factors, multiple genes, and the complicated ecosystems of our bodies and the environments that affect them), and science is a basic process of incremental advancement in understanding how cancer works. Second, there are social barriers that impede progress on the cancer front. Among these are politics, distractions, misconceptions, profit motives, and conflicts of interest.

To break through some of these barriers, BCAction launched the Think Before You Pink® (TB4UP) campaign in 2002. The campaign calls for consumers to make conscious choices about pink ribbon purchases, as well as greater transparency and accountability from corporations and organizations that participate in breast cancer related programs and promotions. Calling out “pinkwashers,” those companies that claim to support the cause of breast cancer but at the same time manufacture, produce, or sell products that may be linked to the disease, TB4UP is an innovative response to the plethora of pink ribbon products that flood the marketplace each year in the name of breast cancer awareness and fundraising.

Now in its tenth year, TB4UP has compiled all that critical thinking to give us a toolkit that provides all of us with a range of approaches and actions to put our critical thinking to effective use. The Think Before You Pink Toolkit brings together information about the effects of pink profiteering and pinkwashing—all in one place. The 22-page toolkit is available for free here. Offered as a first step in changing the conversation about breast cancer and creating systemic change, the toolkit:

  1. Gives consumers an opportunity to learn about the politics of breast cancer, the history of the pink ribbon, the background and successes of the TB4UP campaign, and key facts about the breast cancer epidemic that compel meaningful action;
  2. Provides information to share with others including insights into the runs and walks, ideas about using social media to change the conversation, a TB4UP quiz, critical questions that conscious consumers can ask before making a pink ribbon purchase, and why a “better than doing nothing” approach to corporate fundraising is just not good enough and;
  3. Suggests ways to act now to end pinkwashing, to increase the transparency of pink ribbon promotions, and to hold companies, organizations, and legislators accountable to their stated claims that ending the breast cancer epidemic is a priority.

I often ask people to consider how the idea of “awareness” really functions in American society now that the pink ribbon has become such a popular part of consumer culture. Taken together, do the thousands of common awareness campaigns that encourage people to “get your pink on” and “join the fight” work simply to generate visibility of the cause and encourage people to feel good about being part of it? Do the awareness/fundraising campaigns focus more on marketing and branding to sell products and generate revenue streams than they do on sharing truths about breast cancer that do not fit so neatly in a sound bite? Does the proliferation of the pink ribbon symbol galvanize people to take meaningful actions to eradicate cancer and provide a continuum of care to the diagnosed, or does it just create an impression that something is being done?

Could awareness be deeper than this? More effective? Could campaigns be more focused on information and actions that would really make a difference for those living with the disease as well as help people to understand the breast cancer epidemic and work toward ending it?

Yes, it could.

Though one wouldn’t know it from the pink slogans and products that bombard the marketplace during and beyond Pinktober or the ongoing public relations spin about the infallibility of pinkness, there are already those who are committed to moving beyond the superficial awareness that pink has come to represent. BCAction’s TB4UP toolkit is a shining example. It encourages attentiveness, conscious knowledge, and actions that promote systemic change. It moves beyond simple awareness. It speaks louder than pink. We can, too.

To support the work of Breast Cancer Action and the free education tools they provide, please make a year-end donation today. As a thank you for your year-end donation, you’ll receive theThink Before You Pink toolkit.


Gayle A. Sulik is a medical sociologist, author, and health advocate whose work focuses on the impact of illness on individuals, families, and communities. Her recent book Pink Ribbon Blues: How Breast Cancer Culture Undermines Women’s Health (Oxford, 2011) highlights the hidden costs of the pink ribbon as an industry, one in which the cause has become a brand name with a pink ribbon logo. For more information, go to

The Source—Fall/Winter 2011 | 12.14.11© 2011, Breast Cancer Action ISSN #1993-2408, published quarterly by BCAction. Articles on detection and treatment do not constitute endorsements or medical advice but are intended solely to inform. Requested annual donation is $50, but no one is refused for lack of funds. “Breast Cancer Action”, “Think Before You Pink” and the BCAction logo are the registered trademarks of Breast Cancer Action. All rights reserved. Not to be used without express written permission.

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