We’re All ‘Aware’ of Breast Cancer. It’s Time to Do More.

With one in eight women diagnosed in their lifetime, what we need is less pink and more action.

By Gila Pfeffer | October 20, 2022 | 2:55pm

In Depth

We’re All ‘Aware’ of Breast Cancer. It’s Time to Do More.

Photo:Dominique Charriau/WireImage (Getty Images)

When Katie Couric announced recently that she’d been diagnosed with early stage breast cancer, I whooped, “Hallelujah!” To be clear, my excitement was not about her having a life-threatening disease, rather that a famous person with a huge platform was sharing her story in the hopes that women everywhere would take heed and, more importantly, take action. “Please get your annual mammogram,” Couric wrote in an essay on her website. “I was six months late this time. I shudder to think what might have happened if I had put it off any longer.”

With October and its tired barrage of played-out pink ribbons upon us, Couric’s timing couldn’t have been better. Her story will save more lives than the pink-washing of ten Octobers ever could.

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Over the past decade, countless companies have jumped on the pink wagon by incorporating the color into their October marketing, knowing full well that the average consumer won’t ask what portion of proceeds (if any) actually goes towards research and patient care. The NFL “celebrated breast cancer awareness” in 2012 by outfitting players in pink cleats, gloves, and towels (but missed a perfectly good opportunity to promote manual self-exams by referring to touchdowns as “feel downs,” if you ask me). Danica Patrick posed next to a pink Chevy she’d be racing in support of awareness, KFC launched an absurd campaign called “Buckets for the Cure,” and Delta Airlines painted huge pink ribbons on its planes. (The irony that some of these companies make carcinogenic products gets lost amidst the pink.) Breast Cancer Awareness Month is played out, and I propose that we eliminate it all together. In fact, I think it’s actually hurting, not helping, the cause by being so easy to ignore.

“It’s almost like people become desensitized to all the pink and have a ‘yes, breast cancer is bad, but it’s not happening to me’ attitude about it,” Emily Goldberg, head genetic counselor at JScreen, told me. JScreen’s aim is to get people to have genetic testing done, which would allow them to make better health decisions. “And for all the amazing educational events out there, it’s so much jammed into one month that things get lost and people get burned out; they tune it out.”

Awareness is passive. As a breast cancer previvor/survivor and someone who lost both her young mother and grandmother to the disease, I’ve been aware since I was a little girl. But awareness is not what ultimately saved my life: action did. I was 20 years old when my mother died, and that’s when I started seeing a breast specialist for screenings. My doctor taught me how to do a thorough manual self-exam, which I’d perform every month religiously until my next visit, when she’d do one as part of my screening. At 30 I had my first mammogram, and at 33 I tested positive for the BCA1 gene. At 34 I was a mother of four little kids and opted to have a preventative double mastectomy with reconstruction. The surgery revealed early but aggressive cancer already growing in one breast. Preventative action saved my life.

I was 11 years old in 1985, when October was first established as Breast Cancer Awareness Month, in a partnership between the American Cancer Society and what is now AstraZeneca. Its original aim was to promote mammography as the best way to fight the disease. In 1993, Evelyn Lauder founded the Breast Cancer Research Foundation and made the pink ribbon—first handed out by the Susan G. Komen Foundation to participants in its “race for breast cancer survivors”—the official symbol of the disease. Awareness helped, but a new report by the American Cancer Society found breast cancer rates have increased by .5 percent every year, likely due to high obesity and declining fertility rates among women. One in eight U.S. women will develop breast cancer in her life, with the highest mortality rates among Black women.

It’s almost like people become desensitized to all the pink and have a ‘yes, breast cancer is bad, but it’s not happening to me’ attitude about it.

“Breast cancer action needs to go on all year round, and the important part is having an ongoing dialogue with your doctors,” says Dr. Robyn Roth, a breast radiologist who disseminates digestible, actionable breast health facts on Instagram and TikTok under the handle @theboobiedocs. She believes that a monthly self-exam is a vital part of prevention and a woman’s first line of defense, the operative word being “monthly.” Hyperfocusing on breast cancer for one month out of the year leaves women jaded and exposes the remaining eleven months, Roth says, making Breast Cancer Awareness Month potentially dangerous.

Dr. Eleonora Teplinsky, a breast and gynecological oncologist, says she wants to see the focus shift from awareness to action as well. “How can I act to help reduce my risk and help others who are living with early stage or metastatic cancer?” is what she’d like her patients to think. By virtue of the fact that they’re coming to see her, they clearly already have an awareness, so what’s needed is a deep familiarity with their bodies, a solid knowledge of any family history of cancer and other diseases, and a willingness to explore risk through genetic testing and counseling.

I’d been speaking up about breast cancer prevention for years before my surgery. I brought it up with friends, doctors, and some women I’d met in college who’d also lost their moms to cancer. When an alumnus of my high school was diagnosed with breast cancer at 28 and founded Sharsheret from her chemo chair so that other young, newly diagnosed or at-risk women had a place to turn for support, I joined as a volunteer. One thing my community did not lack was awareness; to know me was to know about the risk of breast cancer.

When my surgeon called me on Thanksgiving eve in 2008 to deliver the news of unexpected malignancies revealed by my pathology, she was as shocked as I was. This was five years before Angelina Jolie’s explosive op-ed about her own BRCA1 positive status and subsequent preventative mastectomy sent droves of women for screenings and preventative procedures—without a single pink ribbon needed.

It didn’t take long for the word to spread to my family and friends who then ran—not walked—to schedule doctors’ appointments and screenings of their own. My diagnosis was a wake-up call to my siblings. Two of my three younger sisters tested positive for the BRCA gene as well and quickly reversed their decisions to not prophylactically remove their breasts. I’d saved their lives, too.

I am not alone in wanting to show Breast Cancer Awareness Month the door. Fellow survivors, breast health specialists, and activist groups like Breast Cancer Action (whose “Think Before You Pink” campaign runs every October to demand transparency from companies claiming to be supporters of the cause) feel that enough people are aware that breast cancer exists.

Throwing a coat of pink on a product does little more than sell more of that product to unsuspecting consumers with the best of intentions. What we want is action taken towards prevention and more effective (and affordable) treatments.

Gila Pfeffer is an essayist and humorist whose work has appeared in the New York Times, Mcsweeney’s, AARP, and more. She promotes breast cancer prevention through a tongue-in-cheek Feel It On the First campaign on her social media, and is currently working on a memoir about outsmarting her genetic destiny with chutzpah and humor.