Feb 4, 2013

How long Breast Cancer Continues Kill Women?

The pink ribbon campaign has been an overwhelming success in raising awareness of breast cancer; yet there is fear that it has lulled women into false hopes for a cure.

The Susan G. Komen Race for the Cure® first introduced the pink ribbon to participants in the fall of 1991 and it became the official symbol for National Breast Cancer Awareness Month in October 1992.

It is unquestionable that the ribbon achieved its purpose in raising awareness of breast cancer and the importance of early detection. However, some women fear that, what they call “Pink Ribbon culture,” has had some unintended consequences.

Behind the Pink Curtain: False Hopes?

Gayle Sulik, author of Pink Ribbon Blues (2010), feels that the optimism and hope inspired by pink culture is giving women the false impression that there is a cure for breast cancer. Has pink ribbon culture encouraged the dissemination of pink misinformation?

Fran Visco, President of the National Breast Cancer Coalition (NBCC), states in her January 21, 2012, Huffington Post article, “WARNING: Breast Cancer Awareness Month May Be Hazardous to Your Health,” that women who read the news are building a false comfort zone, most probably believing:
“if they take care of themselves and get regular mammograms, the disease could be found early and there would be a 98 percent chance of a cure.”
Peeling Away the Pink

“Peeling Away the Pink,” was the slogan of the 2010 NBCC Annual Advocacy Training Conference. In her introductory letter to the Conference, Visco ends by saying, “No more fighting breast cancer with hope.”

A year later Visco announced “Breast Cancer Deadline 2020” at the Summit on the Prevention of Metastatic Breast Cancer, held August 26-28, 2011. Deadline 2020 demands the eradication of breast cancer within a decade.

What is the Truth about Progress in Prevention or Cure of Breast Cancer?

Susan Love, M.D., author of Dr. Susan Love’s Breast Book, has written five editions of the book over the course of twenty years. In the Fifth Edition she writes:
“…I have become increasingly frustrated that we have not made equal progress [with cancer of the cervix] in finding the cause of breast cancer.”
The same concern is shared by the Susan G. Komen for the Cure® organization, who requested a status report on the most current breast cancer prevention information from the Institute of Medicine of the National Academies of Science.

The report, delivered on December 7, 2011, announced that little proof exists that any environmental factor, with the exception of smoking, increases the risk of breast cancer. In the conclusion of the report it states:
"In order to identify additional opportunities to reduce breast cancer risk, further research needs to fill a host of knowledge gaps."
Incidence of Breast Cancer and Cure Rates

The statistics of the American Cancer Society show no change in the incidence of breast cancer in the past five years. The number of deaths also remains constant.

In an article by Sulick, “Why Do I Research Pink Ribbon Culture?” she points out the lack of actual progress in curing breast cancer:
  • Incidence rates remain high, and some forty thousand women and hundreds of men die from the disease each year.
  • Whereas about 25 percent of diagnosed women have a tumor in situ (confined within a duct or lobule) which is not life threatening, the remaining 75 percent are diagnosed with cancer that is actively spreading.
Pink Ribbon Culture: from Awareness and Support to a Culture of Survivors

Sulik describes pink ribbon culture as an attitude of optimisim and hope; and adulation and stories of “she-ro”s, – women who vanquish and transcend cancer, rising from the experience transformed.

In actual fact, she writes, the vast majority of them never had the disease.
Most "survivors," had ductal cancer in situ (DCIS), a tissue abnormality, that even doctors do not agree should be named “cancer.”

Dr. Love defines DCIS as a confined, non-invasive tissue abnormality that looks like cancer cells. It may become cancer, but in the majority of cases, does not. The treatment for DCIS is prevention of cancer by total mastectomy or lumpectomy followed by radiation, because, as Dr. Love states:

“Unfortunately, we don’t know how to tell which cases will come invasive and which won’t.” (Love 2010, p. 331)

Unintended Consequences of the Survivor Culture

Sulik complains that the "she-ro's" have set too high a bar for the 75% of women diagnosed who have deadly invasive cancer.

Stage 4, the most lethal and fast growing cancer, cannot be detected by mammography. Yet the message of the Pink Ribbon is that mammography and early detection will keep women safe.
According to Sulik, some women who she interviewed with Stage 4 breast cancer felt unwelcome and out of place at upbeat, optimistic breast cancer support meetings and were even asked to leave if they were negative or depressed.

Trivializing Breast Cancer

Sulik accuses Pink Ribbon culture of “trivializing” breast cancer. She believes that the manner in which some women depict their triumphs causes other women to believe that breast cancer is not a threat to their lives, but rather a normal experience for women.

She cites a passage in the book, Cancer Vixen, (Marchettio, 2009):

“Cancer, I am gonna will kick your butt.” “And, and I’m gonna do it in killer five-inch heels.” (Sulik, 2011, p. 96)

This cavalier attitude disturbs Sulick, whose closest friend died from a swift, vicious and devastatingly lethal form of breast cancer.

Sulik explains that, by glorifying the victorious female warrior over breast cancer, pink ribbon culture is beginning to “backfire:”

It keeps women ignorant, rather than aware of the deadly threat posed by breast cancer.
Sadly, it has effectively chased the most seriously ill back to hiding and silence.

Dr. Love Asks the Question

Dr. Susan Love approached basic scientists and asked the question – “…why they did not do breast cancer research on women [as opposed to laboratory studies].” One scientist said:

“I don’t know where to find the women.” (Love 2010, p. 633)

She then founded the Dr. Susan Love Foundation with a goal of recruiting women willing to be subjects in forthcoming studies of breast cancer.

HOW: The Health of Women Study

A cohort study is a study that follows healthy people through questionnaires over a long period of time, like The Nurse’s Health Study of Boston, which followed thousands of women over time and discovered a host of risk factors for chronic disease.

With internet communication, Love anticipates the participation of millions of women throughout the world, in the hopes of finding the key to preventing breast cancer.

The Issue is not Pink or no Pink - it is Prevention and Cure of Breast Cancer

Some women feel that Pink Ribbon optimism is distracting women from the lack of progress in breast cancer research. Regardless of how individual women feel about the Pink Ribbon campaign, the answer lies in action. Dr. Love and the HOW study is the best news about breast cancer in decades.


Lerner, BH, “Pink Ribbon Fatigue,” New York Times, October 11, 2010.
Love, Susan M., MD. Dr. Susan Love’s Breast Book. 5th Edition. Philadelphia: Da Capo Press, Perseus Books Group, 2010.
National Breast Cancer Coalition Fund Annual Advocacy Training Conference, May 22 – 25, 2010. http://act.breastcancerdeadline2020.org/site/DocServer/NBCC_2010_Conference_Program.pdf?docID=1782. Accessed December 15, 2011.
Sulik, Gayle A. Pink Ribbon Blues, New York, Oxford University Press, 2011.


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