Opinion: Oncology Nurses Should Know the History of the Pink Breast Cancer Awareness Ribbon

Debi Fischer, MSW, BSN, BA, LCSW, RN

October is Breast Cancer Awareness month. This disease is relentless and again back in the news. This past week, TV journalist Katie Couric, revealed she had received a diagnosis of breast cancer in June. Couric, age 65, has been treated with radiation and a lumpectomy. She had her mammogram taped in real time to raise awareness about screening just as she had done to raise awareness with her colonoscopyafter her first husband died from colon cancer in his forties.¹

Breast cancer awareness has been in the media spotlight for many years now. At hospitals across the country, RNs and social workers wear pink to raise awareness of this cause. Branding is powerful. AIDS related causes use red, and organ donation goes with green. I was curious as to why breast cancer related causes had a pink theme. As ironic as it seems, this was not a Madison Avenue campaign from New York.

This was the brainchild of Charlotte Haley from Simi Valley California in 1991. Charlotte Haley was not in the public relations business. Her goal was to simply create some attention around breast cancer. At age 68, 3 of her close family members had gone through the battle with breast cancer. She began raising awareness in the grocery store by handing out postcards with 5 peach ribbons. Interestingly, by many accounts, peach was the first color recognized for breast cancer awareness. Peach eventually evolved into pink.

The postcards that Charlotte Haley handed out explained that only 5% of the National Cancer Institute’s annual budget out of $1.8 billion was earmarked to prevent cancer in general.² The ribbon was supposed to create attention and it did; both through word-of-mouth and though catching the attention of major newspapers. Before Instagram, Tik Tok, and brand influencers, newspapers created a firestorm around causes. As Haley was handing out ribbons in 1991, by 1992, the New York Times had dubbed the year as “The Year of the Ribbon,” on account of other ribbons gaining attention, such as the yellow ribbons associated with the First Gulf War in 1991 and the red AIDs awareness ribbons from that same year.

However, the grassroots efforts of Haley gained national attention once Alexandra Penney, Self magazine editor and Estee Lauder of the cosmetics firm, became involved. Penney wanted to use Haley’s ribbons as part of her second annual “Breast Cancer Awareness Issue.” Haley was uninterested, she felt they were too corporate and commercialized. However, Penney’s legal counsel advised her that if they changed the ribbon to a different color, they did not need Haley’s permission. Breast cancer ribbons were born. The peach color was left behind.³

Coincidentally, the Susan G. Komen for the Cure® Foundation has been affiliated with the color pink since its start in 1982, although they did not begin handing out pink ribbons until 1991. From the mid-1980s to the early 1990s, their brand design used a pink ribbon with a woman running. Since 1990, pink was the color used to identify breast cancer survivors. When women ran in the Komen Race for the Cure in New York, pink ribbons were given to all runners and disease survivors alike. Again, Alexandra Penney of Self wanted to get involved. Unlike Haley, the Susan G. Komen for the Cure® Foundation was interested in working with Penney. The result was a pink ribbon which Penney enlisted cosmetic companies to distribute throughout New York City stores.

Now, just like a stop sign is universally red, breast cancer awareness is universally pink. And although any generic pink ribbon can be used to represent breast cancer awareness, the Komen “running ribbon” is reserved solely for use by Susan G. Komen for the Cure®, the name the foundation officially adopted in 2007.⁴ They also decided to create a new brand recognition item, that is, a new pink “running ribbon.”

As I read about Katie Couric, I wondered how many oncology nurses had heard of Charlotte Haley. I hope nurses in all specialties will honor her work and pay tribute to Couric’s advocacy by educating their patients about breast cancer risk and emphasizing the importance of early detection.

References

1. France Respers, L.Katie Couric reveals she was diagnosed with breast cancer. CNN. September 28, 2022. Accessed October 1, 2022. https://cnn.it/3CzhJId
2. Waxman, O. Wearing a pink ribbon for breast cancer awareness? Here’s how awareness ribbons became a thing. TIME. October 1, 2018. Accessed October 1, 2022. https://bit.ly/3Cwgn0P
3. In memoriam: Charlotte Haley, creator of the first (peach) breast cancer ribbon. Breast Cancer Action Website. Accessed October 1, 2022. https://bit.ly/3C9kLl4
4. The pink ribbon story. Susan G. Komen for the Cure. Accessed October 1, 2022. https://bit.ly/3SQkIBu