Rhetorical Analysis — “The Problem With Pink”

In “The Problem With Pink,” Peggy Orenstein, a breast cancer survivor herself, brilliantly dismantles the ubiquitous pink ribbon campaign for skeptics of the efficacy of the administration of earlier and more frequent mammograms by citing a number of credible scientific studies, debunking the false hope and fear perpetrated by advocates, and sharing compelling evidence from her own experience with the disease. In the article, Orenstein boldly slaughters the sacred cows of the breast cancer awareness movement, including the disingenuous nature of early screening, the ravenous funding hunger of organizations like the Komen Foundation, and the empty platitudes offered by businesses brandishing pink ribbons in an attempt to divert attention from their own social transgressions.

Orenstein’s authority on the subject is as close to unimpeachable as one could achieve. Not only has she survived breast cancer twice, she did so the first time as a poster child for early detection. She has written numerous books and essays as an advocate for female empowerment, and was named by The Columbia Journalism Review as “one of its ’40 women who changed the media business in the past 40 years’”(Orenstein). Her target audience is an ambitious one, as there is hardly a woman alive who isn’t bombarded with the chronic awareness campaign for early and frequent breast cancer screening, but men and corporate donors should heed her message as well; their support and their money may be better spent elsewhere. Orenstein makes a fantastic case for repurposing funds towards hard research on metastatic disease and lowering the emphasis on early detection, which can often do more harm than good. She also addresses the psychology and motivation behind the awareness movement, and reveals its unsavory truths.

The most critical point of Orenstein’s analysis is the most rational: “…scientific evidence indicates that getting mammograms every other year if you are between the ages of 50 and 74 makes sense; if you fall outside that age group and still want to be screened, you should be fully informed of the downsides” (Orenstein 70). Throughout the article, she not only dissects the ineffectiveness of earlier screening, but the dangers, both physical and psychological, of unnecessary screening. She brings the point home to her own experience, where she states, “By coincidence, just a week after my diagnosis, a panel convened by the National Institutes of Health made headlines when it declined to recommend universal screening for women in their 40s; evidence simply didn’t show it significantly decreased breast-cancer deaths in that age group. What’s more, because of their denser breast tissue, younger women were subject to disproportionate false positives — leading to unnecessary biopsies and worry — as well as false negatives, in which cancer was missed entirely” (Orenstein 38). She has the honest hindsight to admit that the news was, at first, insulting, but later admits, “What if I had skipped my first mammogram and found my tumor a few years later in the shower? It’s possible that by then I would have needed chemotherapy, an experience I’m profoundly thankful to have missed. Would waiting have affected my survival? Probably not, but I’ll never know for sure; no woman truly can. Either way, the odds were in my favor: my good fortune was not just that my cancer was caught early but also that it appeared to have been treatable” (Orenstein 42). The author is pragmatic enough to admit that her condition may not have been aided at all by the early diagnosis.

And while the value of early diagnosis is questionable, the harm of the over-awareness campaign is certain. Orenstein is particularly critical of the excessive emphasis placed on diagnosis of ductal carcinoma in situ (D.C.I.S.), a condition that is often so benign that, “Autopsies have shown that as many as 14 percent of women who died of something other than breast cancer unknowingly had D.C.I.S.” (Orenstein 42). The panic often induced by this diagnosis is nearly criminal. “There is as yet no sure way to tell which D.C.I.S. will turn into invasive cancer, so every instance is treated as if it is potentially life-threatening. That needs to change, according to Laura Esserman, director of the Carol Franc Buck Breast Care Center at the University of California, San Francisco. Esserman is campaigning to rename D.C.I.S. by removing its big “C” in an attempt to put it in perspective and tamp down women’s fear. “D.C.I.S. is not cancer,” she explained. “It’s a risk factor. For many D.C.I.S. lesions, there is only a 5 percent chance of invasive cancer developing over 10 years” (Orenstein 42). The author goes on to paint a narrative of what these reckless D.C.I.S. diagnoses can lead to, after reading a story on The American Cancer Society’s web site. “In a first-person narrative, she said that she began screening in her mid-30s because she had fibrocystic breast disease. At 41, she was given a diagnosis of D.C.I.S., which was treated with lumpectomy and radiation. “I felt lucky to have caught it early,” she said, though she added that she was emotionally devastated by the experience. She continued screenings and went on to have multiple operations to remove benign cysts. By the time she learned she had breast cancer again, she was looking at a fifth operation on her breasts. So she opted to have both of them removed, a decision she said she believed to be both logical and proactive. I found myself thinking of an alternative way to describe what happened. Fibrocystic breast disease does not predict cancer, though distinguishing between benign and malignant tumors can be difficult, increasing the potential for unnecessary biopsies. Starting screening in her 30s exposed this woman to years of excess medical radiation — one of the few known causes of breast cancer. Her D.C.I.S., a condition detected almost exclusively through mammography, quite likely never would become life-threatening, yet it transformed her into a cancer survivor, subjecting her to surgery and weeks of even more radiation. By the time of her second diagnosis, she was so distraught that she amputated both of her breasts to restore a sense of control.” (Orenstein 43). The reality that this culture of fearmongering is leading women to unnecessarily mutilate themselves is one that few in the industry want to hear, but that women need to know, and the author does a fantastic job of expressing.

If selling fear to women of all ages is the meat and potatoes of organizations like the Komen Foundation, then selling false absolution to corporations is the cherry on the sundae. Orenstein describes the pervasiveness of the marketing: “…millions of pink-garbed racers “for the cure” as well as legions of pink consumer products: pink buckets of chicken, pink yogurt lids, pink vacuum cleaners, pink dog leashes. Yet the message was essentially the same: breast cancer was a fearsome fate…” (Orenstein 39). One has to pause and wonder if all of this pink product placement is really that altruistic. The “pink buckets of chicken” probably kill more people from obesity-related maladies than they ever will save through breast cancer awareness. In some cases, the motives of these corporate sponsors are more patently dubious. “With its dozens of races “for the cure” and some 200 corporate partnerships, it may be the most successful charity ever at branding a disease; its relentless marketing has made the pink ribbon one of the most recognized logos of our time. The ribbon has come to symbolize both fear of the disease and the hope it can be defeated. It’s a badge of courage for the afflicted, an expression of solidarity by the concerned. It promises continual progress toward a cure through donations, races, volunteerism. It indicates community. And it offers corporations a seemingly fail-safe way to signal good will toward women, even if, in a practice critics call “pinkwashing,” the products they produce are linked to the disease or other threats to public health. Having football teams don rose-colored cleats, for instance, can counteract bad press over how the N.F.L. handles accusations against players of rape or domestic violence. Chevron’s donations to California Komen affiliates may help deflect what Cal OSHA called its “willful violations” of safety that led to a huge refinery fire last year in a Bay Area neighborhood” (Orenstein 43). In the years since the publication of this article in 2013, the N.F.L.’s record on domestic abuse has only grown worse, but they’re still spending a month of every season putting wife beaters in pink socks as if it somehow makes it all better.

Six years on, Peggy Orenstein’s essay remains a clinic in flipping the script on the exploitative nature of the breast cancer awareness movement. She deconstructs the statistical and emotional arguments for excessive screening and through her own anecdotal experience and the citation of a number of medical experts illustrates how the cause has been usurped by the corporate greed not only of its parent foundations but that of its sponsors seeking to buy goodwill and credibility through the support of a fight that everyone agrees needs to be fought, but few should agree with how we’re actually fighting it.

Works Cited:

Orenstein, Peggy. “About” www.peggyorenstein.com

Orenstein, Peggy. “ The Problem With Pink” New York Times Magazine; Apr 28, 2013 pg. 36