Seth Godin defines a brand as “the set of expectations, memories, stories and relationships that, taken together, account for a consumer’s decision to choose one product or service over another. If the consumer (whether it’s a business, a buyer, a voter or a donor) doesn’t pay a premium, make a selection or spread the word, then no brand value exists for that consumer.”

In other words, a fancy trademarked logo is not enough to make a brand. A brand must inspire people to spread the word about your “product.” One of most powerful ways to do this is through an emotional connection that encourages consumers to identify with the brand message.

Nike’s “Just Do It” slogan with accompanying “swoosh” logo dared consumers to take action and challenge themselves. Igniting a purpose beyond the mere purchase of gear, the company tapped into an American belief about the importance of hard work and getting ahead. Many brands are designed to influence how people think of themselves. Am I classic, trendy, healthy, , rugged, interesting? In the context of Nike's product line, “doing it” also meant engaging in physical activity that likely required Nike gear. But it was the message not the product that led to sales.

The pink ribbon works in a similar way. It functions as a logo for a “set of expectations, memories, stories and relationships that, taken together, account for a consumer’s decision to choose” the breast cancer brand.

The breast cancer brand draws from a collection of symbols, images, and meanings within pink ribbon culture to maintain the principal message that breast cancer is a vitally important cause, and that supporting it indicates good will toward women. The brand encourages people to buy and display pink in the name of increased awareness, improvement in women’s lives, faith in medical science, and hope for a future without breast cancer. The brand capitalizes on emotional responses related to of the disease, hope for a cure, and the goodness of the cause.

FEAR

, or the use of fear to influence the opinions and actions of others towards some specific end, is a key emotional dimension of the breast cancer brand. Fear mongering often involves repetition to reinforce the intended effects of this tactic, and the feared object or subject is sometimes exaggerated.

The mock advertisement for a Breast Cancer Research Foundation (BCRF) campaign found on Pinterest uses ominous coloring to bring to the potentially lethal danger of one’s breasts. The skeleton beneath the skin glows red against a corpse-like body. Since the image was posted on Pinterest it may not have run as an official print advertisement for BCRF. However, the message fits the general fear-mongering framework.

Women are ten times more likely to die from heart disease than from breast cancer, and they are also more likely to die from cancers of the respiratory (71,550 per year) and digestive (59,810 per year) systems than they are from breast cancer (40,170 per year). Yet widespread statistics seem to indicate that breast cancer is almost inevitable, and research studies that do not clearly explain what risk really means give the impression that almost anything and everything will contribute to the development of breast cancer.

HOPE

Although it has not been shown to have survival benefits, many representations of breast cancer depict the same story of hope, courage, and joyous inspiration.

Clinical health psychologist at the University of Pennsylvania and Co- of the Cancer Control and Outcomes Program at the Abramson Cancer Center at Penn, Dr. James Coyne points out that having a positive outlook may bring benefits to cancer patients, but there is no evidence that it prolongs life. One of the largest studies to date on attitudes and cancer showed no link between and cancer risk or survival. People who think optimistically get cancer and die from cancer at the same rates as people who do not. Yet hope is marketed as the cornerstone of triumphant survivorship.

“Imagine” was recognized by AdAge as one of the “best ads in weekly news magazines” for 2008. “The model’s eyes appear to be fixed directly on the reader,” said Michael Galin. “Direct eye contact has been...linked with high levels of reader involvement…due to its capacity to command attention and increase the sense of and connection with the ad’s content.”

Such emotional appeals remind people of what they generally believe in and encourage them to act. Ads focus on beliefs in the inevitability of scientific progress and the goodness of the breast cancer cause. The actions are then prescribed. Have hope. Join the fight. Buy the stuff. Tell your friends. Imagine a future without breast cancer.

The dream of eradication fuels passion and participation in the cause. But without clearly defined , aligned actions, valid indicators of progress, systematic and continuous evaluation, and flexibility when evidence suggests needed change, how is such a dream possible?

In 2006, there were some 2.5 million women living in the United States who had been diagnosed with breast cancer. In 2013, the American Cancer Society estimated over 232,340 thousand new cases of breast cancer among women and 2,240 new cases in men, along with over 40 thousand deaths. Although 80 percent of new cases were in women over age fifty, a growing number were diagnosed at earlier ages. Nearly 33,000 newly diagnosed women in 2008 were under the age of forty-five. The National Cancer Institute reports that mortality rates for invasive breast cancer have improved from a rate of about 31 deaths per 100,000 people in 1975 to about 23 deaths per 100,000 in 2007. Over a span of 32 years, that’s eight fewer deaths per 100,000 people. These data do not support the premise that society is on a path to eradication.

GOODNESS

The breast cancer brand encourages individuals and corporations to support the cause through consumption and , with mass media offering representation for those who participate. Active members of the breast cancer audience are cast as good, great, generous, committed, and doing their part.

Similar to other “thons,” the breast cancer walks correlate moral worth, volunteerism, and individual responsibility for one’s health (i.e., “Doing good by running well” as Samantha King argues in Pink Ribbons, Inc. Those who take part (individuals and corporations) build a civic based in consumption and symbolic commitment.

In addition to supporting a good cause, pink consumption is cast as an enjoyable and satisfying lifestyle choice. Another print ad in the series asks readers directly: “When was the last time you had a really GREAT WEEKEND?” The focus is on personal fulfillment. A third ad reads: “Good things come to those who WALK.” In other words, good people who do something good will receive good things in return. This sentiment once again calls upon the reader to reflect on his or her values and actions. Images of happy people engaging in fun activities suggest that good things come to those who pink.

Emotional manipulation aside, the representations that circulate in cancer culture use simple associations to depict a narrow dimension of reality that juxtaposes fear of breast cancer with hope for the future and the goodness of the cause. The breast cancer brand keeps the war going, but it does not represent the reality of the disease.

Dr. Gayle Sulik is the author of Pink Ribbon Blues: How Breast Cancer Culture Undermines Women's Health. More information is available on the book's website.

© 2013 Gayle Sulik, PhD ♦ Pink Ribbon Blues on Psychology Today