I may be a breast expert, but I find it difficult to write about Breast Cancer Awareness month.

It could be that I’m all pinked out, or too knowledgeable from years of research and study. It may be tied to my painful childhood memories.

When I was ten years old, my mother was diagnosed with breast cancer. In those days no one talked about the disease, much less shared information about the experience. My mom had no say in her medical treatment. She found a lump, was prepped for surgery, and her doctor made a decision while she was still under anesthesia. He performed a radical mastectomy: removing not only her right breast, but muscle tissue, lymph nodes, and sweat glands. Arriving home from the hospital, my father helped her undress for her first post-opt shower. I remember her long, painful cry as she uncovered the 36-inch, jagged scar left on her chest. Thankfully, she’s alive today and will soon celebrate her 93rd birthday.

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This month marks the 25th anniversary of National Breast Cancer Awareness and almost 20 years of employing pink ribbons to raise funds for the cause. Two recent books trace the history and progress made by decades of  “awareness.” Samantha King’s Pink Ribbons, Inc. was published in 2005 and is the basis for a new Canadian documentary of the same title. Gayle Sulik’s Pink Ribbon Blues hit the bookshelves last year. Both provide insight into the social and psychological implications of tying pretty, pink ribbons around breast cancer. Each author includes an analysis of the big business of cause marketing, who profits and how close we are to finding a cure. It's clear from their investigation that funding for medical research is less valued than reminders to perform breast self-exams or schedule mammography screenings. As Sulik points out, “how many awareness campaigns does one person need?”

Bringing public attention to breast cancer has given women more power and authority in directing their medical care. Mortality rates are lower, but not in all populations---most notably women of color and the poor. Statistics show that incidence of breast cancer has fluctuated, partly due to mammography and a decline in the use of hormone replacement therapy. But there’s been no significant reduction in the annual 12 percent (or 1 in 8 women) diagnosed with breast cancer. New surgical techniques are employed and doctors no longer rely on disfiguring and traumatizing radical mastectomies. Innovative, customized drug therapies are available. These treatments prolong lives, but not without troubling side effects. Survivors are not “in the pink” of health again.

The ribbon may be unraveling, A recent study in the Journal of Consumer Research shows that women are less likely to pay attention to messages wrapped in pink advertising. Investigative reports confirm that many pink profiteers give little back to legitimate breast cancer causes. (Check out Breast Cancer Action’s Think Before You Pink campaign before making a donation.) Breast cancer survivors are speaking out about “pinkwashing,” and those who exploit their suffering. Awareness has touched one unintended audience. A survey by BreastCancer.org found that 30% of young girls 8-18 years of age believe they are at risk of developing breast cancer, an astonishing number given the rarity of the disease in their age group.

I may or may not beat the odds. Even without my mother’s diagnosis, I find myself in two top risk categories: I’m female and I’m aging. And I’m hyper aware, thank you, without rosy reminders. I do wonder whether my 21-year-old daughter will face similar choices. When she was born I broadcast her gender to the world with pink bows wrapped around her hairless head. She could wear those ribbons again. But they would symbolize disease, disability, and loss. Not the power and potential of future womanhood.