A Review of the Pink Ribbon: Has the

corporatization of the breast cancer movement

been the result of the pink ribbon movement, and
is this necessarily a bad thing.
Gregory M. Fisk Jr.

CH-99
Social Movements in Public Health
Tufts University

Abstract: Breast cancer is the second leading cause of death in American women

(CDC). There is no straight cure for the disease, and on top of being deadly,

it can be a demoralizing and de-feminizing situation. That is why the breast

cancer movement is sitting in second place, only to the HIV/AIDS movement,

as one of the most successful and powerful social movements. With the

implementation of the pink ribbon, the movement became substantially more

powerful and financially superior to any other cancer movement. Using

articles from people within the movement itself, and articles demonstrating

the duality of the ribbon, this essay will try to explain how the pink ribbon

movement got to where it is today, why a backlash from people within the

movement is beginning to develop, and if the corporatization of the

movement is a positive or negative state of affairs.

Introduction
The ribbon as a symbol of a movement began with the yellow ribbon. This ribbon was

used in the Iranian Hostage Crisis of 1979 (Pershing, & Yocom, 1996). This was put out

to show that the hostages were not forgotten, and that whoever put out the ribbon wished

for their safe return (Pershing, & Yocom, 1996). There have been red, orange, green,

blue, yellow, peach, and many other types of ribbons that represented movements of

issues, but the pink ribbon has come to be one of the most prominent of its kind. When

breast cancer adopted the pink ribbon, the movement’s awareness exploded. It has raised

money and put breast cancer on the map. But was it necessarily a good thing? Some

people in the movement do not believe so, and this is making some noise. However the

positives of the pink ribbon movement within the breast cancer movement, overall,

outweigh the recent criticisms that have been brought to attention. The problem is, if the

movement does not look internally to make a change, breast cancer will be a complete,

commercialized corporation in just a few years. Using literature talking against the

movement, and using the research and positive outcomes that the movement has created,

I will show how, even though the movement has lost some of it’s grass-roots, it has made

a larger impact than it could have ever made on its own. I will also discuss how in

continuing this trend, the movement could potentially completely lose their roots, and the

disease and the people who survived, and are suffering from it today, will be lost to

commercial products that support it.

Rationale

Breast cancer research is now a multibillion-dollar industry. In 2007 alone, the National
Cancer Institute (NCI) spent $572.4 million on breast cancer research, the National

Institutes of Health (NIH) spent $705 million, and The Susan G. Komen for Cure

Foundation raised $162 million ("Breast cancer action," 2009). The Susan G. Komen for

Cure Foundation is the main non-governmental foundation for breast cancer research.

Starting in the 1980’s, they now have a plethora of cooperate sponsors. Avon, BMW,

Bristol Myers Squibb, Estée Lauder, Ford Motor Company, General Electric, General

Motors, J. C. Penney, Kelloggs, Lee Jeans, and the National Football League all now

partner with the Susan G. Komen for Cure Foundation (King, 2004). Just the pure

amount of money that is put into research and fundraising makes this topic intriguing. Is

it more important to keep a grassroots movement out of the cooperate arm, or are the

millions of dollars raised more important? Is letting breast cancer be used as a selling

point for companies less important than the significant of the disease itself, or is it more

important to find a cure? These questions are hard to answer. Over 210,000 women are

diagnosed with breast cancer in a year, and over 40,000 of them die (CDC, 2009). But,

Lung and Bronchus, Digestive System, and Male Genital System cancers all have a

higher rate of mortalities than breast cancer, and, Colon, Rectum, and Female Genital

System cancers have rates close to that of breast cancer ("United states cancer," 2005).

So, it is hard to say that the significant amount of money breast cancer research receives

is fair in respects to the other diseases that people suffer from. On top of that, the fact

that breast cancer out shadows many, if not all of the other forms of cancer because of all

it’s cooperate sponsorships seems unfair in itself. So the issues that the breast cancer

movement has all factor in to their internal respect of the health social movement and of a
cancer movement, and the external respect of other movements.

Background

History of Breast Cancer, the disease

Breast cancer is the uncontrollable multiplication of the cells primarily in the milk ducts

(ductal carcinoma) or glands (lobular carcinoma) ("Webmd: breast cancer," 2009). The

cancer, while mainly in the breast, can spread to other areas such as the lungs, liver, or

bones, and is treated as breast cancer even if found in those areas ("Webmd: breast

cancer," 2009). There are multiple types of breast cancer. The most common forms are

Ductal Carcinoma In-Situ (DCIS) (early breast cancer confined to the inside of the ductal

system), Infiltrating Ductal Carcinoma (IDC) (most common and deadly type of breast

cancer), Medullary Carcinoma (usually occurs in women in their late 40s and 50s),

Infiltrating Lobular Carcinoma (ILC), Tubular Carcinoma, Mucinous Carcinoma (most

favorable prognosis), and Inflammatory Breast Cancer (IBC) ("National cancer institute,"

2009). The treatment plans for all of the types of cancer all have the same goal: get the

cancer out of the body and prevent it from returning. Some therapies include surgery

(mastectomy or lumpectomy), radiation therapy, chemotherapy, hormone therapy, and

biological therapy ("Webmd: breast cancer," 2009). Doctors differ in approaches, and

treatment also differs with they type and stage the cancer is in.

Before the early 20th century, breast cancer wasn’t on the charts of most common deaths,

and it did not have a large compilation of data on detection, prevention, and cures
("Breast cancer action," 2009). It was not until the 1920’s that an invention was created to

help detect the cancer itself ("Breast cancer action," 2009). This invention was called the

mammogram. The mammogram takes x-ray pictures of the breast and exposed lumps in

the breast if there were any ("National breast cancer," 2009). It also shows if the lump isa

cist (a fluid filled lump that is not cancer), or a solid, cancerous mass ("National breast

cancer," 2009). It was able to detect up to 85% of breast cancer tissue ("National breast

cancer," 2009). With this invention, breast cancer could now be detected before it was

too late, and was a start for finding a cure. Later on in the 20th century, women were

beginning to be taught how to give self-breast examinations and how the mammogram

could be life saving ("National cancer institute," 2009).

Along with the raise in awareness of the disease, the science community began to become

more aware as well. Advances in molecular biology allowed more facets of breast cancer

to be uncovered ("National cancer institute," 2009). BRCA1 and BRCA2 were

discovered as a result of this ("National cancer institute," 2009). BRCA1 is a mutated

gene that raises the risk of breast cancer in whoever has it ("Webmd: breast cancer,"

2009). It is considered breast cancer in the early onset stage. BRCA2 is a mutated

protein in the body that is considered a type 2 susceptibility protein, which could

eventually lead to breast cancer ("Webmd: breast cancer," 2009). Knowing about the

genes now explained why doctors saw a family lineage of breast cancer, and allowed

people who have had the disease in the family find out if they also had the mutated genes

("Breast cancer action," 2009).

History of the Movement

Before the movement, women who had breast cancer did not have much say in what they

could do about it, and were not able to ask questions (Norsigian, Diskin, Doress-Worters,

Pincus, & Sanford, 1999). Instead, they were quickly put under the knife, and received

mastectomies, leaving them with no breast (Norsigian, Diskin, Doress-Worters, Pincus,

& Sanford, 1999). Imagine going to the doctor, being basically forced into surgery, then

waking up without one of your defining physical features and THEN being told you had

breast cancer. It is something no woman or person should have to go through, and this is

where the movement took off.

The seemingly private and option-less disease was now being brought into the public eye,

thanks to a book and a woman’s public battle with breast cancer. The beginning of the

movement focused on publicizing and de-stigmatization the idea of breast cancer. In the

1973, the Boston Women's Health Collective published the book, Our Bodies, Ourselves

(Norsigian, Diskin, Doress-Worters, Pincus, & Sanford, 1999). The book empowered

women and tried to teach women to take control of their health outcomes and taught them

it was ok to ask questions and what questions to ask (Norsigian, Diskin, Doress-Worters,

Pincus, & Sanford, 1999). The second factor was in 1974, when the First Lady Betty

Ford revealed she had been diagnosed with breast cancer. Ford talked about her disease

to the public, and because of her position in the public eye, she was able to reach many

other women who were silently suffering from breast cancer. People began talking about
what they were going through, and women started to get their first mammograms

(Norsigian, Diskin, Doress-Worters, Pincus, & Sanford, 1999). Without Betty Ford, the

movement would not have started so smoothly. Another main achievement of the early

movement was an improvement in the treatment process. A two-step treatment for

women diagnosed with breast cancer now allowed women to make a decision about what

they wanted to do (Norsigian, Diskin, Doress-Worters, Pincus, & Sanford, 1999). Now,

women who had possible breast cancer had biopsies on the tumor to see if it was cancer,

and once the diagnosis came back, they were given a few days to mull the options, and

make an informed decision (Norsigian, Diskin, Doress-Worters, Pincus, & Sanford,

1999). This is far different than before, when women found out they had breast cancer

AFTER they woke up from surgery with either one or both breasts removed (Norsigian,

Diskin, Doress-Worters, Pincus, & Sanford, 1999).

The movement then took on a lull while the HIV/AIDS movement took center-stage. But

in the early 90’s, it erupted again. This time, the goal of the movement was not to simply

raise awareness, but they now wanted to terminate the disease altogether. Top

organizations like the National Breast Cancer Coalition, Breast Cancer Action, the Susan

G. Komen for the Cure Foundation, and others wanted to stop breast cancer from

happening ("Breast cancer action," 2009). Local organizations began to form, and the

movement began focusing on getting money for breast cancer research. Lobbying

campaigns, a letter-writing campaign, and political activism lead to a $341 million

increase in federal funding for breast cancer research, $89 million in 1991 to $430
million in 1993 (Kolker, 2004). Now, breast cancer research receives the most amount of

money from the government, receiving more money than any two other cancers

combined, and has received over $1.5 billion from 2006-2008 ("National cancer

institute," 2009).

History of the Pink Ribbon

The ribbon became a symbol first in 1979, when a

wife of one of the Iranian Hostage crisis but a

yellow ribbon on a tree (King, 2008). It

represented her wish to see her husband again

(Pershing, & Yocom, 1996). The next ribbon to

hold a meaning was during the Gulf War. People

used that same yellow ribbon to show their support

of the troops and their desire of a safe return home

of our troops (Pershing, & Yocom, 1996). Then,

the HIV/AIDS movement adopted the red ribbon to

raise awareness, and now the ribbon appeared alongside multiple movements ("Think

before you," 2009). Even the New York Times called 1992 “The Year of the Ribbon”

("Think before you," 2009).

This is where the Susan G. Komen Breast Cancer Foundation wanted to join the ribbon

madness. After distributing pink visors at many of its Race for the Cure events, the

foundation began to give out pink ribbons to participants also ("Think before you,"

2009). Then, in 1992, the editor in chief at Self Magazine decided to, along with the

Breast Cancer Awareness Month issue, create a ribbon (King, 2008). She went through

the major cosmetic company Estée Lauder, and wanted to distribute the ribbon in all the

New York City stores, and the senior corporate vice president, and breast cancer survivor,

Evelyn Lauder, promised to put the ribbon on all cosmetic counters across the country

("Think before you," 2009). But the commercialization of breast cancer through the

ribbon already created some backlash. A granddaughter, sister, and mother of breast

cancer survivors were already making peach colored ribbons that raised awareness about

the funding of breast cancer ("Think before you," 2009). Self Magazine wanted to work

with this woman, but Charlotte Haley did not want to work with them ("Think before

you," 2009). Why? Haley believed Self was too commercial, and wanted to keep her

grassroots beginnings (King, 2008).

This is how the color of pink was chosen, by process of elimination. ““Pink is the

quintessential female color,” says Margaret Welch, director of the Color Association of

the United States. “The profile on pink is playful, life-affirming. We have studies as to its

calming effect, its quieting effect, its lessening of stress. [Pastel pink] is a shade known to

be health-giving; that’s why we have expressions like ‘in the pink.’ You can’t say a bad
thing about it.” Pink is, in other words, everything cancer notably is not” ("Think before

you," 2009). In 1992 alone, 1.5 million ribbons with self-examination cards were passed

out ("Think before you," 2009). And then the pink ribbon took off.

Today, major companies like Avon, BMW, Bristol Myers Squibb, Estée Lauder, Ford

Motor Company, General Electric, General Motors, J. C. Penney, Kelloggs, Lee Jeans,

and the National Football League all now partner with the Susan G. Komen for Cure

Foundation (King, 2004). All have pink ribbons in their commercials, on their products,

and with their logos. The reason for this? It turns out that breast cancer has no negative

connotations, and that is the perfect situation for marketing. Unlike HIV/AIDS, or lung

cancer, or other diseases that can be caused my life choices, breast cancer is not a result

of drug users, smokers, or other negative products. Also, companies think, “Who would

not want to support breast cancer?” Cause-related marketing arrived with the pink ribbon.

Some companies market their products with the pink ribbon, but in reality, one could

barely notice the difference from the non-breast cancer product. New Balance shoes did

this, and the pink ribbon on the tongue of the shoe could barely be seen when tied

("Think before you," 2009). Yoplait yogurt, which had “pink lids” actually contained

rBGH (Recombinant Bovine Growth Hormone), which may lead to breast cancer ("Think

before you," 2009). So this is where the issue lies, has the commercialization of the pink

ribbon, and in turn, the breast cancer movement, been a good thing rather than a bad

thing. I think you need to discuss how some of the profits from these products went to

breast cancer research

Pink Ribbons, Inc

Written by Samantha King, Pink Ribbons,

Inc. is one of the leading pieces of literature,

arguing against the corporatization of the

breast cancer movement. King tracks the

history of breast cancer, from the early stages

to now, and she talks about how the

movement and search for the cure has become

a selling point for multiple corporations. She

openly holds reservations on the authenticity of the corporations that are supposedly

trying to stop and prevent breast cancer. She argues that the individual battles and the

real search for the cure are lost in the endless commercials and products that companies

slap pink ribbons onto. King also points to the idea that the act of philanthropy is losing

its meaning because now, any person who buys a yogurt considers themselves a

philanthropist. This intriguing book is one of the main counterarguments to the thesis of

this essay. While King does make sense in a lot of her arguments, it is hard to truly prove

that the revenue and awareness the pink ribbon has made is a bad thing.

Methodology

To help prove the point that the partnership the organizations and corporations have is a

positive one, I will use articles on the positive impacts of research that was funded by the

organizations, of support groups, and of research studies on the effectiveness of raising

awareness of early detection. Everything from new technologies, to new genetic

understandings of the disease, to new procedures all comes from research. There also has

been new research revising older assumptions about mammograms about the frequency

and when one should start getting mammograms. Every organizational website has

dozens of research and journal articles, that they supported, that help everyone slowly

uncover the mystery of the disease. Without the funding that the pink ribbon and

government produce, it would be hard to pay for all the research being done.

Research was done through the organizational websites and the research articles that were

funded by them, JSTOR, PubMed, and the Tisch library website at Tufts University,

articles and books (Pink Ribbons, Inc.) from people involved within the movement (both

positive and negative), and by talking to actual survivors of breast cancer.

Cause-Related Marketing

Cause-related marketing is probably the main term used in most anti-pink ribbon articles

and books. Cause-related marketing is a marketing

strategy of a corporation to market their product with the

addition of helping a non-profit organization, like the

Susan G. Komen Foundation for the Cure and A&A

Optical, Accessory Network, ACH Food Companies, Inc.,

Acushnet - Titleist, Cobra and FootJoy Worldwide, Adams

Media, Aftermarket Auto Parts Alliance, Inc, American

Airlines, American Italian Pasta Company, Anchor Bay Entertainment, Ansell Healthcare

Products, LLC, Arizona AFO, Ask.com, ATP Electronics, Inc, Autobiography of

SORAYA, and Avery Dennison (that is just the A’s section of the list of corporate

sponsors on the organizations website). Companies see raises in sales when they put a

non-profit organization on the box. It makes sense. If someone sees that Cheerios has

the American Heart Association on the box, they will likely be more likely to buy it than

if it did not have it on the box. Corporations that give money to a cause are technically

philanthropist organizations. Society looks positively on altruism and helping a good

cause, but the problem is, these corporations are not being altruistic. How do you know

they are not? Are they ALL not? Maybe it would be better to say “but the problem is, not

all of these corporations are being altruistic.

There are multiple reasons breast cancer has been the movement most affected by cause

related marketing. First, because of the success of the movement itself, breast cancer is a

highly public and de-stigmatized disease. Second, it affects 200,000 women in a given

year (CDC, 2009), which means that millions of people directly experience and see the

struggle. And finally, this disease does not discriminate, and there is not much a woman

can do to prevent it from happening. There is no controversy around the life decisions of

the people who are diagnosed with breast cancer, and there is nothing truly negative

about the disease. It is unlike HIV/AIDS (injection drug users, homosexuality, etc.) and

lung cancer (cigarette, tobacco usage). So breast cancer is the perfect combination for a

corporation to latch on to.

Engagement Experience

For an engagement experience, I went to talk with two women that were diagnosed with

lobular carcinoma in sutu, a genetic precursor to cancer. I learned about what they went

through to find out and to solve the problem, about how they felt throughout the whole

process, and what they thought of the pink ribbon. Both were prevented from getting

breast cancer because of this early finding. So, when told about the controversy around

the movement, and asked for their opinions, both believed the pink ribbon was a good

thing. They believed that early detection and raising awareness is still a very important

issue. They also believed that the amount of money, along with the awareness that the

pink ribbon makes is a great way to prevent women now from dying from breast cancer,

and to provide research to eliminate breast cancer completely. To these two women who

profited greatly from the breast cancer movement and the pink ribbon, they believe it is a

good thing. And when something like that comes from breast cancer survivors, the

people that the movement is all about, it holds a lot of weight.

Findings

The findings are clear, but at the same time unclear. Breast cancer research receives the

most funding than any other cancer research. They receive more funding than lung and

prostate cancer, the two most common cancers in the US, combined (“National cancer

institute," 2009). Some may say it is unfair, but 1 in 8 women will experience breast

cancer in their lifetime, a higher rate than any other cancer ("American cancer society,"
 2009). Breast cancer patients also now have the second highest survival rate of any

cancer at 91% (right behind prostate cancer at 99%) ("American cancer society," 2009).

But the rate has risen 2% ("American cancer society," 2009) every year since 1990; that

is over 35% since the pink ribbons have been around. Also, organizations like the Susan

G. Komen Foundation for the Cure, The Canadian Breast Cancer Foundation, and the

National Cancer Institute have funded research on new surgeries like subcutaneous

mastectomies with immediate reconstruction that limit the time women have to be in bed,

breast-less (Ashikari, Ashikari, Kellerman & Salzberg, 2008), new procedures like

stereotactic large-core needle breast biopsies that are less discomforting and painful than

the old biopsies (Hemmer, Kelder, & van Heesewijk, 2008), and new diagnostic

machines like an MRI’s that detect breast cancer (Jacob, Causer, Warner, & Martel,

2009). With the recent studies showing that the tough, physical mammogram may

actually cause cancer ("RSNF", 2009), the new MRI technology may save more lives.

Five-Year Survival Rates FY08 Federal Research Dollars Per Death

(Cancer Facts and Figures 2009, American (NIH, DOD, CDC Combined)

Cancer Society)
Both charts help illustrate the extreme funding breast cancer receives, but also the success

of the movement and funding by showing the rise in survival rates over the years.

So while it is true that the pink ribbon has become a corporate image, and in turn, breast

cancer is being used for corporate gain, it still is producing so many positive outputs.

Discussion

The discussion to the question whether or not the corporatization of the pink ribbon is a

good thing or not is hard to determine through simple research. It is also hard to argue

for one side of the other knowing only a few people’s opinion. When talking to people

who have suffered and benefitted from the research, funding, and awareness that the pink

ribbon has had an effect on, they do not see the problem with how the ribbon is

functioning. To them, it is simply a way for breast cancer to stay in the public eye, and

raise a lot of awareness and money for the movement. For people like Samantha King,

author of Pink Ribbons, Inc., the pink ribbon turning into a corporate symbols seems to

be a negative and harmful development. The argument for the ribbon is the grand stage
that it has been put on by all the corporations, and the argument against the movement is

the loss of the grassroots beginnings.

Conclusion

Over the last twenty years, there has been a substantial amount of research done on breast

cancer. We now know that genetics can affect whether or not some has breast cancer; we

know multiple procedures to prevent high-risk patients from getting it, to cure people

who have it, and to limit the psychological damage a mastectomy can take ("Breast

cancer action," 2009). It is hard to argue against the pink ribbon. It has made numerous

positive effects, and nothing can be perfect. The corporatization of the pink ribbon is a

good thing, and it far outweighs the negative effects of possibly diluting the survivors

itself, and losing the meaning of the disease itself. The goal of the breast cancer

movement is to prevent and slowly eliminate breast cancer. Less women and men dying

is the goal, and the pink ribbon is tremendously helping the movement do just that.

Practical implications and recommendations

The anti-pink ribbon movement is forcing the breast cancer

movement to take a look at themselves. Self-criticism is the

best way for a movement to improve. The cause-related

marketing of the pink ribbon also makes companies morally responsible to aid the

movement, and already, a company has changed their product because of this. Talked

about before, Yoplait had rBGH in its yogurt, a hormone that may cause breast cancer
("Think before you," 2009). But because of the “pink lids”, they were in essence forced

to change their product, and now are rBGH free ("Think before you," 2009). Cheerios

also made their cereal healthier because of its alliance with the American Heart

Association. Cause-related marketing can be a good thing, and that is without taking into

account the millions of dollars they raise over the years and the millions of people the

cause is exposed to.

Final Reflections

Without activism, every problem of the world would go unsolved. But it is not only

about having people who care (even though that is a necessity). Resources, connections,

and just pure luck are all important in making a difference. When Our Body, Ourselves

came out, luckily enough, the First Lady of the United States of American just so

happened to be diagnosed with breast cancer at the same time. (What effect did that

have? Maybe include something like, which brought the issue further into the eye of the

American public. On a more local scale, when Shape Up Somerville (SUS) started off, it

just so happened that a young, athletic, enthusiastic mayor in Joseph Curtatone was

elected. He made SUS his priority and took pride in it. Who is to say SUS would be

what it is today without him. And the true key to anything is going to the people who

you are trying to help. That is the one main lesson that I will take away from the course.

Talking to women who survived breast cancer about the pink ribbon was the turning

point in my train of thought. If women who were directly affected by the disease think

nothing of the corporatization of the pink ribbon, even after hearing all the facts and
stories arguing against it, then how could I be? Community health is not called Health of

the community because the community comes first, not second. Once you fix the

community, then the health will be fixed, too.

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