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A breast-cancer awareness banner is displayed before a game at Indianapolis's Lucas Oil Stadium on Oct. 10.

Scott Boehm/Getty Images

"I get nauseated when I walk into a drugstore and see little tins of mints in pink," says Joan Sirrs, 73, kick-starting the group discussion over tea at the Ottawa Rideau Tennis Club after a fitness class for breast-cancer survivors.

"And all those pink products everywhere. You think, 'ugh.' "

"It's not all bad," says Sheila Waugh, 72. "But it's a commercialization of my disease and I really object to that."

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"One per cent is better than zero per cent," counters Tracey Davis, 40. Last night she bought pink-ribbon mushrooms at the grocery store.

The good side they agree upon - cancer isn't hidden. Says Ayse Heinbecker, 67, diagnosed two years ago: "It's allowed women to talk about breasts."

But is it time to have a different conversation?

The women in Ottawa aren't the only ones conflicted, critiquing the pink ribbon campaign even with their pale pink jackets slung over their chairs. (When her mother had the disease, Ms. Davis, a communications adviser with Revenue Canada, thought her dad went "over the top" buying pink - now her closet is full of it.)

Online, scores of cancer survivors express downright hostility at Pink October. We're awash in it: from food, cars and motorcycle helmets to pink cleats on football players and pink-clad models (Elizabeth Hurley tweeted last month that she needed 22 pink dresses for her fundraising appearances). One night this month, the Parliament buildings in Ottawa were doused in pink. At a recent Nascar rally, the crowd chanted, "Go Pink or Go Home!"

There's no licence on a generic pink ribbon - the Canadian Breast Cancer Foundation owns its logo, which includes a ribbon - so companies can adopt the cause and show "support" for breast cancer without necessarily offering up any chase.

In the United States, there have been some questionable pink pairings: Even as new research is linking breast cancer to high-fat diets and over-consumption of alcohol, KFC promised this spring to donate 50 cents for every bucket of fried chicken sold and "Support Her" vodka promised $5 toward "prevention" for every bottle sold.

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"If shopping could cure cancer this would be over by now," says Angela Wall, a spokesperson for Breast Cancer Action San Francisco, which runs a campaign called Think Before You Pink and argues that the main beneficiaries of pink products are corporations. "This is marketing by emotional hijacking."

But like Ms. Davis, most of us would choose the give-to-a-good-cause mushrooms. Companies are counting on it. And who's got time to read the fine print on those pink products that says there's a cap on those after-profit contributions? Or that the donation from the yogurt company only happens when you mail in the lid?

Buy a pink crocodile make-up case from Estée Lauder if you think it's pretty - but the purchase doesn't add to the predetermined $500,000 donation, the company's website says.

The roots of the cancer campaign are often traced back to a California grandmother named Charlotte Haley, who made peach ribbons in her living room and distributed them at cancer clinics with her grandson, raising awareness but accepting no money. The pink ribbon, adopted in 1993 by a cosmetics company, does deserve credit for changing attitudes about breast cancer and improving early detection.But today, critics suggest that "awareness" is an outdated, too-passive message. Social scientists are studying whether buying that pink ribbon makes consumers complacent about doing more.

Facebook's campaign that asks women to change their profile to add innuendos about where they stash their purses may lead to a quick chat about the quirky campaign, but does it get anyone closer to preventing or curing the disease?

And when donations happen, asks Ms. Sirrs: "Who follows up on where all the money is going?"

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The pink campaign has always treated early detection as synonymous with prevention. But many scientists now believe the focus should be on the causes of breast cancer, and say that early screening may be subjecting women to unnecessary treatment for non-fatal tumours.

Susan Love, a prominent California oncologist and surgeon who runs a cancer-research foundation, points to cervical cancer as a model: "In 30 years, we went from cutting out body parts to creating a vaccine," she says. That's what needs to happen for breast cancer, she says.The overwhelming presence of the pink ribbon, some worry, has also squeezed out other critical illnesses from donations. Heart disease and strokes kill more women than breast cancer, and dementia affects more women than men - both as patients and caregivers. Fundraising for mental illness and Alzheimer's still suffer from the stigma that once kept breast-cancer patients silent. The Breast Cancer Foundation's Run for the Cure this month raised $33-million - 10 times the amount raised by the Alzheimer's Society's Walk for Memories.

According to a 2007 Canadian study, breast cancer gets $1 of every $4 spent on site-specific cancer research - nearly double the amount for both colorectal and lung cancer, which are more deadly.

"You want to keep your cause front and centre," suggests Gordon Floyd, CEO of Children's Mental Health Ontario, and a former vice-president of the Canadian Centre for Philanthropy. "But I do think it would be appropriate for people in that movement to think hard about whether it's time to take their foot off the accelerator for a while and ensure they're not taking dollars from other causes that need it more."

One sign of a shift: This August, the Weekend to end Breast Cancer became the Weekend to end Women's Cancers, a recognition of the science linking gynecological cancer to breast cancer. But breast cancer still dominates. "We have a long way to go," says Sandra Palmaro, Ontario CEO of the Canadian Breast Cancer Foundation. "The complexity of the disease requires more investment."

Ms. Palmaro acknowledges the criticisms about the pink ribbon. The foundation, which relies on cause marketing for $6-million of its $47-million budget (about 60 per cent of which goes to awareness, education and research), has declined partnerships with sponsors for ethical reasons, and advises companies to be transparent about donations.

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And consumers, Ms. Palmaro suggests, should ask for details when shopping.

Joan Sirrs and her group at tea would just rather the burden didn't lie so heavily on them to make sure all the corporate pink-washing still feels clean.

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