A history of breast cancer awareness and activism

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1990s: MONEY TALKS | According to "A Historical Perspective on Breast Cancer Activism in the United States," the increased attention to breast cancer led to extremely positive results like the formation of the Breast Cancer Research Program (BCRP) by the Department of Defense and increased funds for breast cancer research. Lobbying on the part of the NBCC and two separate petitions to Congress that garnered more than 3 million signatures total helped raise awareness and large amounts of funding for breast cancer research. After the formation of the DOD's BCRP, $210 million was earmarked for breast cancer research. Since its formation, the BCRP has <a href=https://cdmrp.army.mil/bcrp/received more than $3 billion in congressional appropriations, according to the DOD website.

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1990s: BREAST CANCER ACTIVISM BOOM | Taking its cue from the AIDS activists of the 1980s, breast cancer advocacy became much more politically charged during the 1980s and into the 1990s, according to "A Historical Perspective on Breast Cancer." The article notes that organizations emerged with defined political agendas aimed toward increasing visibility and funding for breast cancer research while driving policy decisions.

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2000s: THE FIGHT AGAINST BREAST CANCER CONTINUES | According to a 2011 article in Marie Claire by Leah Goldman, close to $6 billion is raised toward breast cancer research and awareness annually. The National Breast Cancer Foundation reports on its website that it has provided more than 192,000 mammograms and more than 240,000 breast health services to women, while Komen for the Cure reports investing more than $956 million into research. According to its website, the National Breast Cancer Coalition has allowed more than $3.75 billion in federal dollars to be devoted toward breast cancer research.

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1990s YOU CAN'T LOOK AWAY | The world at large also got a front-row seat to the implications of breast cancer when noted photographer Joanne "Matuschka" Motichka appeared on the cover of New York Times Magazine baring her post-mastectomy scar under the headline "You Can't Look Away Anymore," as part of her own support for the breast cancer movement. Though some were offended by the jarring photo, the image garnered a number of positive responses and shed new light on the fight against breast cancer.

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1990s: A SYMBOL IS BORN | Though it is now a ubiquitous symbol for breast cancer awareness, the pink ribbon also has a storied history. According to Time magazine and Think Before You Pink, 68-year-old Charlotte Haley, a breast cancer patient whose mother, grandmother and daughter also battled the disease, developed the breast cancer ribbon. Following the lead of previous efforts like the anti-war and AIDS movements, Haley began distributing looped, peach ribbons with cards advocating for breast cancer research funding. Haley's idea got a mainstream boost when Susan G. Komen for the Cure, which had already adopted the color pink for its branding, handed out pink ribbons instead of pink visors at its New York City Race for the Cure. In 1992, Alexandra Penney, then the editor-in-chief of Self magazine, collaborated with cosmetics giant Estée Lauder to distribute pink ribbons in stores in tandem with the release of Self's second annual breast cancer awareness issue.

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1990s: SUPPORT AND ADVOCACY | In the late '80s, several local support groups were consolidated to form the National Alliance of Breast Cancer Organizations. The 1990s also saw the rise of several prominent breast cancer support and advocacy groups including 1 in 9, Sisters Network, Inc., the National Breast Cancer Foundation, the National Breast Cancer Coalition (NBCC) and Breast Cancer Action.

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1990s GENE CLONING | According to the National Cancer Institute, between 1984 and 1995, the HER2, BRCA1 and BRCA2 genes were discovered and cloned, shedding new light on some of the possible underlying causes of breast cancer. For HER2, the National Cancer Institute says, overexpression of the gene's protein is associated with more aggressive forms of breast cancer with worse prognosis. BRCA1 and BRCA2 can both carry mutations that increase the risk of breast cancer in men and women. According to the American Cancer Society's 2019-2020 Facts & Figures report, other gene mutations that are linked to different diseases and disorders have been correlated with increased risk of breast cancer. This includes TP53, which is associated with Li-Fraumeni syndrome and PTEN, which is associated with Cowden syndrome.

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2000s: THE FIGHT AGAINST BREAST CANCER CONTINUES | According to Cancer.org, the incidence of breast cancer began to decrease at the turn of the century. Between 1994 and 2004, invasive breast cancer rates decreased by 13%. The American Cancer Society's 2019-2020 Facts & Figures report points to decreased use of menopausal hormone treatments as a possible cause for the downward trend. Since that time, however, incidences have crept up, though the less invasive ductal carcinoma in situ (DCIS) cancer, which affects the milk ducts, decreased by 2.1% by 2016. On the whole, breast cancer death rates are down for all races, according to the Facts & Figures report. While incidence rates for all began to inch back up as the aughts drew to a close after mostly leveling off during the early 2000s, incidences have slightly decreased again since the mid-2010s.

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2000s: A TARNISHED SYMBOL | Even the once symbolic pink ribbon has been reduced to a corporate gimmick. Today, its emblazonment on merchandise doesn't necessarily mean a consumer is donating to a worthy cause with every purchase. "Skip the pink-ribbon merchandise," Goldman cautions in her article. "Because no one really owns the rights to what has become the universal symbol of breast cancer (though Susan G. Komen for the Cure trademarked its own version), peddling the logo has become a massive racket, overrun by slick profiteers exploiting the public's naive assumption that all pink purchases help the cause. Often they don't."

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1970s: WOMEN'S LIBERATION AND WOMEN'S HEALTH | According to Time magazine, the rise of the second women's liberation movement also spawned increased conversations about women's health and, by extension, breast cancer. During this period, according to Time, the first edition of the well-known women's health book "Our Bodies, Ourselves" was published by a group of women in Boston. The book, which released its most recent edition in 2011, details a number of women's sexual and reproductive health issues.

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1970s: WOMEN IN THE DOCTOR'S OFFICE AND IN THE LAW OFFICE | Research from "A Historical Perspective on Breast Cancer Activism in the United States" also indicates that other strides made in the 1970s, like the passage of Title IX laws, created more pathways for women to enter the fields of law and medicine, thus expanding the future ability for women to advocate and receive adequate care for an array of gynecological health concerns including breast cancer.

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1930s: CANCER AWARENESS ON THE RISE | According to the American Cancer Society's website, by 1935,15,000 Americans were involved in what was then called "cancer control." As the 1930s came to a close, the number increased tenfold. It was also during this time that radiotherapy became more prevalent as a treatment option for breast cancer, which would have previously been surgically corrected via radical mastectomy, according to "Understanding Breast Cancer – The Long and Winding Road."

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BREAST CANCER AND RACE | Among other races, breast cancer incidences vary. According to "Breast Cancer Incidence and Risk Reduction in the Hispanic Population," cancer is the leading cause of death among all Hispanics and Latinos in the U.S., but Hispanic women have a 20% lower incidence rate than the rest of the U.S. population. Asian and Pacific Islander women have the lowest mortality rate from breast cancer, while American Indian women come in third behind Black and white women.

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EARLY 20th CENTURY: SILENCE ISN'T GOLDEN | You probably wouldn't recognize (or really be able to have) early 20th-century conversations around breast cancer. The disease was widely regarded as taboo and something suffered in silence but never talked about. "A Historical Perspective on Breast Cancer Activism in the United States: From Education and Support to Partnership in Scientific Research," a 2012 paper published in the Journal of Women's Health notes, "In general, cancer was seen as an incurable disease."

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1910s: EARLY SUPPORT GROUPS | As early as 1913, according to "A Historical Perspective on Breast Cancer Activism in the United States," societies like the American Society for the Control of Cancer (ASCC) (now known as the American Cancer Society) and the Women's Field Army were formed to change the perception of cancer and raise funds toward detection awareness.

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1980s: BREAST CANCER ACTIVISM GROWS | In the 1980s, a number of breast cancer advocacy organizations, including the Susan G. Komen Breast Cancer Foundation, were founded. The 1970s and 1980s also saw the introduction of chemotherapy and the beginnings of targeted treatments like tamoxifen, along with the less-invasive lumpectomy as treatment options for breast cancer, according to "Understanding Breast Cancer – A Long and Winding Road." Ideas about how women should respond to breast cancer were also challenged. Audre Lorde wrote this about her own diagnosis in 1980 in her book, "The Cancer Journals": "I want to illuminate the implications of breast cancer for me, and the threats to self-revelation that are so quickly aligned against any woman who seeks to explore those questions, those answers. Even in the face of our own deaths and dignity, we are not to be allowed to define our needs nor our feelings nor our lives."

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1990s THE ENVIRONMENT | In the 1990s, there was also a push to investigate environmental contributors to breast cancer, as evidenced by the Long Island Breast Cancer Study Project (LIBCSP). The study examined contributing factors to breast cancer in Suffolk, Nassau, and Schoharie Counties, New York, and Tolland County, Connecticut, after the areas were discovered to have the "highest adjusted mortality rates for breast cancer" between 1983 and 1987.

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BREAST CANCER AND RACE | Along with Audre Lorde's narrative, the impact of breast cancer on non-white women began to draw more attention. Ellen Leopold, a writer and breast cancer survivor, acknowledged the gap in attention to breast cancer in Black and other non-white women. Leopold noted that though the death rate for breast cancer in Black and non-white women didn't exceed white women until the 1980s, the lack of recognition non-white women received in their fight against the disease "is the illustration of yet another social and institutional failure for which redress urgently needs to be made."

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1950s-1960s: QUIET STRIDES | One important stride in the fight against breast cancer was the rise of mammograms. According to "Understanding Breast Cancer – The Long and Winding Road," mammography as a detection measure for breast cancer was initially discovered with the advent of the X-ray but became even more common in the late 1940s. By 1962, Robert Egan, a doctor and researcher at Emory University who dedicated his work to finding ways to detect cancer, had used mammography to diagnose 53 instances of breast cancer.

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1970s: BREAST CANCER GOES MAINSTREAM | The 1970s also saw a number of very public women getting diagnosed with breast cancer including former child actress Shirley Temple Black, "Seventeen" magazine editor Babette Rosmond and even first lady Betty Ford. These women began to steer the conversation about breast cancer and challenge existing treatment methods, including radical mastectomies and the lack of biopsies of tumors prior to deciding on a treatment plan. "These disclosures coupled with the political climate of the country, increasing use of the media, the coming of age of the Baby Boomers, the women's health movement, and the controversy regarding breast cancer treatment coalesced to initiate a new era of activism for women affected with breast cancer," according to "A Historical Perspective on Breast Cancer Activism in the United States."

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EARLY 20th CENTURY: SILENCE ISN'T GOLDEN (CONTINUED) | The popular show "Downton Abbey," which takes place in the early 1900s, even explores this concept in the character of Mrs. Hughes, who keeps her discovery of a lump in her breast a secret, sharing it only with a close friend. "What is there to tell?" Mrs. Hughes asks after deciding not to tell her colleague and eventual husband Mr. Carson about her possible diagnosis of cancer: "You must put these things in proportion … and I think I can do that now."

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A BRIEF HISTORY OF BREAST CANCER ACTIVISM | October is Breast Cancer Awareness Month, and while breast cancer hasn't been eradicated, a number of strides have been made toward a cure and improved life expectancy for male and female patients. The American Cancer Society reports that the five-year survival rate for women diagnosed with breast cancer at all stages is 90%. Between 1992 and 2017, the death rate fell from 32 to 19.8 per 100,000 persons. Click through the slideshow to browse the history of breast cancer awareness, notable achievements and roadblocks throughout more than 100 years.

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1940s: ONE WAR ENDS AND ANOTHER INTENSIFIES | By the 1940s and with the close of World War II, the American Society for the Control of Cancer, now going by its current name, the American Cancer Society, was raising millions toward the fight against cancer. It also launched its cancer signs campaign, a longstanding effort to warn people of the indicators of cancer, according to the ACS website.

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BREAST CANCER AND RACE | According to a report from the American Cancer Society, in the 1980s, increased detection of asymptomatic lesions led to a higher incidence of breast cancer in Black women. The report further states that incidences for all types of cancer went up between the 1970s and 1990s for Black men and women. Breast cancer death rates also increased rapidly during this time and actually matched, then surpassed white women. Today, the report states, Black women are more likely than other racial groups to be diagnosed with triple-negative and inflammatory breast cancer, both of which are more difficult to treat and have worse outcomes.

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SUPPORT WISELY | There are a number of ways to show your support with or without purchasing a breast cancer-themed product. The Better Business Bureau has some recommendations for making sure organizations are above board. Regarding purchasing products that claim to support a charity, BBB says, "See if the promotion specifies the specific breast cancer charity that will benefit from the sale. If you are unfamiliar with the charity, check out the charity with BBB to verify if they meet the BBB Charity Standards. Be cautious of sale campaigns that claim to help the breast cancer cause but don't identify any charity by name." If you're going on a walk or race, "see if there is a fee to participate, find out if you are required to sign up a minimum number of sponsors, and research the breast cancer charity to make sure this is a group you want to support."