It’s really inescapable.  No matter where you look – the supermarket, the mall, online news sites – you see it: pink ribbons.  Kids wear pink bands on their wrists; grown men, football players, no less, wear pink sneakers and gloves – all in the name of National Breast Cancer Awareness Month.    

As a woman’s health clinician, I couldn’t be more enthusiastic about breast cancer’s newfound visibility.  Reproductive cancers used to be so taboo that first lady Nancy Reagan‘s breast cancer diagnosis and subsequent surgery were treated with distance and caution by the media in the 1980s. Can you imagine that happening now? 

Celebrities from Christina Applegate to Sheryl Crow to Elizabeth Edwards speak openly about chemotherapy, surgery and mammograms and make appearances at fundraising and awareness events.  The world’s view of breast cancer has changed.

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Or has it?

Despite the publicity, only about three-quarters of eligible women follow recommendations to get annual mammograms. After years of growth, this rate has recently stagnated and even dropped in some areas. Black women remain far less likely than white women to be screened.  And many women still smoke cigarettes, drink alcohol to excess, miss out on physical exercise and otherwise fail to reduce their personal risk for breast cancer.

So, what’s going on?  Has the pink parade replaced actual health care?  I worry that for many people, awareness doesn’t actually provoke action.  And many women remain so confused about what exactly they can do to prevent or detect breast cancer that they do nothing at all.  So, while I’m happy to see cars emblazoned with “Save the Tatas” bumper stickers and read inspiring stories with my morning cereal, let’s re-envision awareness month as a starting point, not as an endpoint. 

Explain breast self-exams to your patients.  Conduct routine clinical breast exams and order mammograms.  Support public health campaigns to fund mammography for low-income women. Fight tobacco use. Lobby for healthier cities and towns. Don’t just think pink; act pink.