Breast Cancer Awareness Month and Its Many Shades of Pink (Blue and Green)

6 min readOct 5, 2021

It’s time to challenge the singular narrative of breast cancer as a female only disease wrapped up prettily in a pink ribbon.

Image Credit: Kathi Kolb, Accidental Amazon

We’re not just heralding the season of mists and mellow fruitfulness but also October brings an omnipresent pink hue which means it’s breast cancer awareness month. — Audrey Birt

While there is no denying that Breast Cancer Awareness Month (BCAM) has played a significant role over the past two decades in raising public awareness of breast cancer, there is nevertheless growing criticism of its off-balance approach to awareness-raising, with many key messages becoming lost in a sea of “pink-washing.”

“BCAM is a 2-sided coin in our community,” states Jean Rowe, Director of Support and Provider Engagement at The Young Survival Coalition [1]. On the one hand, she explains, celebrating successful treatment outcomes and raising awareness is important, but “on the other side, expectations that come with the pink ribbon in October can be overwhelming, isolating, infuriating and bewildering.”

The pink ribbon, so long a symbol of breast cancer awareness and support, has become for many a symbol of what’s missing from the BCAM narrative.

When I first pinned a pink ribbon on myself, I was newly diagnosed with breast cancer. Back then, I felt that wearing a ribbon was a symbol of solidarity, and I wore it proudly. Looking back, I now see that my view of breast cancer was one-dimensional. Standing today on the other side of cancer I see a broader picture, a richer landscape of many shades beyond pink.

A Whiter Shade of Breast Cancer

For Siobhan Freeney, Patient Advocate at European Lobular Breast Cancer Consortium and founder of Being Dense [2], breast cancer is not pink.

“When I see pink I’m reminded of all things feminine, “ she says. “My delayed breast cancer diagnosis resulted in a mastectomy. There’s nothing feminine or pink about that. I see breast cancer as the elusive ‘snowball in a snowstorm’ because my breast cancer, all seven centimetres of it, was missed on consecutive mammogram screenings. I know now that I had extremely dense breasts, this caused a masking effect — white on white.”

Breast Cancer Shaded Blue

Much of the criticism of BCAM centers on breast cancer campaigns which over-sexualize the disease, equating breasts with womanhood and femininity.

Rod Ritchie [3] who was diagnosed with breast cancer in 2014, points out that “October is a bad time for male breast cancer survivors because the trivialization and sexualization of the disease by the pink charities reinforces public awareness that breast cancer is gender specific. Since there’s little attempt to educate men that they need to be aware of symptoms too, we are diagnosed later and have a poorer prognosis.”

Ritchie suggests “adding some blue to the pink, encouraging research on us, and screening those with a genetic propensity. Reminding the community that this is a genderless disease will give us a chance to receive an early diagnosis and therefore a better prognosis. We deserve equality.”

Metastatic Breast Cancer: The Other Side of BCAM

Metastatic breast cancer (MBC, also called stage 4, secondary breast cancer (SBC) or advanced breast cancer) has been referred to as a story half-told, the other side of BCAM we don’t hear enough about.

Breast cancer blogger, Nancy Stordahl [4] is unequivocal in her criticism of the failure each October to adequately raise awareness of MBC. “Despite all the pink, all the races, all the pink ribbons, most people still know little or nothing about metastatic breast cancer,” she writes. “No wonder so many with metastatic breast cancer feel left out, isolated, alone and yes, even erased.”

Read how Marissa Holzer [5]so eloquently captures the feeling of exclusion for MBC patients.

“The crisp fall mornings, the leaves changing color and pumpkin spice everything — I can see it starting already. The pink-tinged products are appearing on store shelves and in my social media feed with the same messages we’ve all heard year after year: “Early detection saves lives.”

A message, which Marissa points out, ignores metastatic breast cancer.

Note: If you wish to understand more about the experience of MBC patients, I highly recommend you read MBC patient advocate, Abigail Johnston’s BCAM related posts on her superb blog No Half Measures [6]

How To Honour All Sides of the BCAM Coin

This article is not meant in any way as a criticism of those for whom wearing a pink ribbon is meaningful. I am grateful that the original pink ribbon movement has brought breast cancer out of the dark ages when it was taboo to even mention the words “breast cancer” aloud. However, time has moved on, and it is time to challenge the singular narrative of breast cancer as a female only disease wrapped up prettily in a pink ribbon.

So to quote, Gayle A. Sulik, a medical sociologist, and author of Pink Ribbon Blues,[7] “this is not a condemnation of anyone who finds meaning in the ribbon or public events. It is a call to broaden the discussion, re-orient the cause toward prevention and life-saving research, and acknowledge the unintended consequences of commercialization, festive awareness activities, and the lack of evidence-based information that makes its way to the public.”

It’s important to honour your feelings and emotions at this time. If you want to celebrate BCAM, celebrate; if you want to sit out this month or use it as an opportunity to educate others in a different way, then do that. In the words of Jean Rowe, “Everyone gets to experience BCAM the way in which they need and want to.”

However, I will add to this that whichever way you choose to honor this month, be more questioning. As Abigail says, “ask if the pink ribbon represents the community you are trying to reach before using it automatically. Be open to understanding that not everyone identifies with the same images and concepts.”

Perhaps consider wearing the more inclusive green and teal ribbon designed by METAvivor [8].To highlight the uniqueness of the disease and show its commonality with other stage 4 cancers, METAvivor designed a base ribbon of green and teal to represent metastasis.

Green represents the triumph of spring over winter, life over death, and symbolizes renewal, hope, and immortality while teal symbolizes healing and spirituality. The thin pink ribbon overlay signifies that the metastatic cancer originated in the breast. — Metavivor

If I can ask one thing of you, it’s this.

Please use this month as an opportunity to broaden your understanding of breast cancer awareness to include metastatic disease.

“I’ve listened to the voices of people with metastatic breast cancer every day for the past year and a half, and my mind and heart have been opened in ways I couldn’t possibly have imagined, “ wrote Dr Corrie Painter, of The MBC Project [9]. “I had so many misconceptions about metastatic breast cancer before working on the MBC project. I’m sure I still do, but each time I get to learn along with the MBC community, I jump at the opportunity. I didn’t even know what I didn’t know, and it never occurred to me to ask questions in order to educate myself on what people with metastatic breast cancer face.”

Above all, this BCAM, don’t let breast cancer awareness in all its many shades be for one month alone. “When I began my advocacy, I hopped on the October bandwagon to bring awareness to a disease that has affected me, my own family, and dear friends too often, “ says Terri Coutee, founder of DiepCFoundation [10]. “ Now, I look at it as only one month out of a year we need to bring awareness to latest studies in oncology, clinical trials, surgical best practices, emotional recovery, support, all mixed in with a bit of gratitude for the friends I’ve made along the way and to mourn those I have lost.”