In breast cancer fight, even Dallas Cowboys 'pinked'

ARLINGTON, Tex. â€" THE Dallas Cowboys just got “pinked.”

And not just the Cowboys. The entire Cowboys Stadium here. Pink is everywhere: around the goalposts, in the crowd, on the players’ cleats, towels and wristbands.

In case you haven’t noticed, October is National Breast Cancer Awareness Month, when the entire nation gets painted pink. This is also when “pink” becomes more than a color: It becomes, for better or worse, a verb.

In marketing circles, “to pink” means to link a brand or a product or even the entire National Football League to one of the most successful charity campaigns of all time. Like it or not â€" and some people don’t like it at all â€" the pinking of America has become a multibillion-dollar business, a marketing, merchandising and fund-raising opportunity that is almost unrivaled in scope. There are pink-ribbon car tires, pink-ribbon clogs, pink eyelash curlers â€" the list goes on.

Down on the 50-yard line on this early October day is Nancy G. Brinker, the chief executive who has done more than any other to create what might be called Pink Inc. With a C.E.O.’s eye, Ms. Brinker has turned her foundation, Susan G. Komen for the Cure, into a juggernaut. She has tied this nonprofit to hundreds of for-profit brands and spread its message far and wide with “Race for the Cure” foot races. She has, in effect, invested to maximize returns. Over the years, Komen has raised many billions of dollars to urge women to get mammograms, as well as for treatment and research.

“It’s a democratization of a disease,” Ms. Brinker, who is the Cowboys’ honorary captain for the day, says just before the coin toss. “It’s drilling down into the deepest pockets of America.”

The story of Komen is, as much as anything, a story of savvy marketing. Ms. Brinker has rebranded an entire disease by putting an upbeat spin on fighting it. Her foundation generated about $420 million in the 2010 fiscal year alone. Perhaps more than any other nonprofit organization, Komen shapes the national conversation about breast cancer.

If you’re feeling hopeful about the strides being made against this disease, rather than frustrated by the lack of progress, that may well reflect Komen’s handiwork. If you think women should be concerned about developing breast cancer, that’s often Komen’s message, too. And if you think mammography is the best answer at the moment, that, again, is the Komen mantra.

Like Big Oil, Big Food and Big Pharma, Big Pink has its share of critics. Some patient advocates complain that Komen and other pink-ribbon charities sugarcoat breast cancer, which kills about 40,000 American women and 450 men annually. Others complain that pink marketing, despite the many millions it raises for charities, is just another way to move merchandise and that it exploits cancer by turning it into an excuse to go shopping. And some pink-theme products have no relationship with any charities at all. (Consumers should check before buying.)

In any case, these critics say, all of those pink ribbons and pink products create more good will for charities and corporations than game-changing medical advances for patients.

Executives at Breast Cancer Action, a San Francisco advocacy group, have questioned the value of pink October for 20 years. They say some charities spend millions more on promoting the medical status quo â€" annual mammography screening, that is â€" than they do on financing research into the causes and prevention of the disease. (Mammography has significantly reduced the death rate from breast cancer, particularly for women in their 50s and 60s. But health experts disagree on whether women in their 40s need routine screening, or whether they should decide individually, in consultation with their doctors, based on risk factors like their family history.)

“The pink ribbons have become a distraction,” says Karuna Jaggar, the group’s executive director.

Ms. Brinker has heard such complaints before. She says Komen has good reason to promote screening and to ensure that people have access to follow-up care, all the while financing research to advance cancer treatment.

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“Do you take care of people today?” asks Ms. Brinker, who served as ambassador to Hungary under President George W. Bush. “Or do you put everything into prevention research?”

Komen spent about $141 million in fiscal 2010 on public health education, including awareness campaigns. It also spent about $75 million to finance medical research and about $67 million to pay for breast cancer screening and treatment. All that, Ms. Brinker says, requires Komen to generate revenue from individual donors and corporate sponsors. And if that means promoting pink KitchenAid blenders, Nascar vehicles or Scotch tape dispensers, so be it.

“America is built on consumerism,” Ms. Brinker says. “To say we shouldn’t use it to solve the social ills that confront us doesn’t make sense to me.”

Heart disease and lung cancer each kill more women in the United States than breast cancer. But the fight against breast cancer attracts more corporate sponsors, in part because of Ms. Brinker.

New Balance, for instance, has “Lace Up for the Cure,” a promotion that donates 5 percent of retail sales of certain pink sneakers to Komen, with a minimum annual donation of $500,000. Yoplait, as part of its “Save Lids to Save Lives,” donates 10 cents per pink yogurt lid to Komen; since 1999, it has given more than $22 million. And this month, even Eggland’s Best eggs come stamped with Komen pink-ribbon logos on their shells.

Of course, Komen does not have a monopoly on pink-ribbon marketing. While the Cowboys have a separate relationship with Komen, there is also an overall N.F.L. pink partnership with the American Cancer Society. And for almost every product, including a beer pong table available on Amazon, there is someone marketing a pink version.

It wasn’t always this way.

Until 1974, when Betty Ford, then the first lady, disclosed she had had a mastectomy, breast cancer was a taboo subject for many. After she went public, the number of women seeking mammograms spiked, in what epidemiologists would call “the Betty Ford effect.”

Several years later, Ms. Brinker’s sister, Susan G. Komen, a mother of two in Peoria, Ill., learned that she had breast cancer. But she didn’t receive aggressive treatment immediately. Later, even intensive chemotherapy could not save her.

In her memoir, “Promise Me,” Ms. Brinker tells how she promised her dying sister she would work to find a cure.

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