The number of firms claiming to be involved in fund-raising efforts for Breast Cancer Awareness Month is growing, sparking a call for more coordination.The great paradox of Breast Cancer Awareness Month, which is held in October, is that as the number of corporate fund-raising campaigns has multiplied, so has the number of women being diagnosed with the disease. This paradox is the thrust behind "Think Before You Pink," a grassroots campaign calling for greater transparency in breast cancer fund-raising efforts. Barbara Brenner, executive director of Breast Cancer Action, which created the campaign, has spent the last three- and-a-half years trying to track where the money goes. But she says she has found little coordination among the nonprofits and federal agencies that coordinate breast cancer research. Brenner, herself a breast cancer survivor, is concerned that the lack of coordination means that there is no guarantee that fund-raising dollars are going toward new research. "The major issues in breast cancer remain unresolved. Nobody's talking about what's happening to treatment," she says. "That's a tragedy and a scandal." The call for greater coordination is actually the latest phase of the two-year-old Think Before You Pink campaign. But the group hasn't strayed from its original focus of taking companies to task on their breast cancer promotional efforts. Brenner recalls a winemaker that put pink ribbons on its labels for Breast Cancer Awareness Month - despite studies indicating that heavy drinking raises the risk of the disease. To these companies, Brenner says, "Don't bother putting a pink ribbon on your product because we will come after you." Dorie Hightower, public affairs specialist at the National Cancer Institute, acknowledges that there is no overarching coordination among research centers. But she notes that such an undertaking would be challenging, not to mention expensive. "I don't think one thing has to do with the other," she says about the rising incidence of breast cancer. "The numbers are going up because of [increased] screening." Susan Carter, director of communications for the Susan G. Komen Breast Cancer Foundation, which partners with many of the pink ribbon's corporate sponsors, notes that cause-related marketing engages consumers "where they live" and generates activism. "Consumers have come to expect corporate America to give back and support causes like the fight against breast cancer," she says, adding that Komen's website includes questions consumers should ask before participating in a fund-raising campaign. "As a nonprofit, we simply do not have the financial resources to conduct large-scale informational outreach." Susan Heaney, director of communications for the Avon Foundation, the nonprofit arm of the Avon Corporation, agrees. "Corporate partners raise the money that's needed," she says, adding that Avon breast cancer walks have raised $300 million to date. "[That] is an extraordinary amount of money." She adds that the Avon Foundation carefully selects what research centers to fund. "There are so many valuable and credible studies," she says. "The cardinal rule of science is that you don't know what you're looking for." A crowded market No one disputes the effectiveness of cause-related marketing. But some marketing and PR experts have questioned whether a breast cancer awareness or promotional campaign is the right route for every company. Cause-related marketing is a particularly effective way to reach women, says Maria Bailey, author of Marketing to Moms: Getting Your Share of the Trillion Dollar Market. "[Women] like to patronize companies that make their world, and the world of their children, better," she says. But Bailey notes that the market is crowded with companies taking part in breast cancer-related campaigns. "Sometimes I wonder if there's saturation," she says, adding that heart disease kills more women than breast cancer, yet breast cancer receives disproportionate attention. And for these campaigns to resonate, companies must keep up the dialogue after October. "It's not enough just to put your logo on a breast cancer event," she adds. "[Women] communicate with brands in the way that we communicate with girlfriends. To a woman, the relationship is trust." It's easy for companies to jump on the breast cancer bandwagon, notes Maria Kalligeros, president and cofounder of PT&Co., an agency that specializes in cause-related marketing. Cause-related campaigns can be risky, but breast cancer awareness has been proven "safe" precisely because of all the companies involved in it, she notes. In addition, there is already a network of nonprofit partners for companies to partner with. She compares breast cancer campaigns to client Liz Claiborne's domestic violence effort. Domestic violence, in contrast to breast cancer, isn't well understood, women are still faulted for being victimized, and a significant portion of the campaign has to correct misinformation, she notes. But just because breast cancer might be "safe" doesn't mean it's the appropriate campaign, she says. "Consumers and the press are too savvy today," she says. "You have to do more than, 'Buy this product and we'll give 10 cents to charity.'" She adds that 50% of a campaign's goals should be moving the social needle, and 50% should be doing right by the company's business objectives. Heaney notes that Avon's female representatives can help customers feel less stigmatized. Carol Cone, president of Cone Communications, also notes that companies need to pick relevant campaigns. For companies that do get involved, Cone recommends targeting certain segments of the demographic, a particular race or age group, for instance. But she disagrees that the market has reached some sort of saturation point. "Compared to a lot of communications, it's not excessive," she says. "Look at Olympics communications; look at Christmas." Striving for change Brenner notes that she has no illusions about overhauling Breast Cancer Awareness Month. "There are too many entrenched interests," she says. But she does want companies to be more explicit about how much money they're donating and where the money is going. Breast Cancer Action is also concerned about the messaging coming out of Breast Cancer Awareness Month. That message focuses too much on detection and not enough on prevention, Brenner notes. She points to mammography, which has become a controversial issue ever since researchers began to question whether this diagnostic test actually reduces the number of deaths from breast cancer. The National Cancer Institute defends the message. "Our job is to push the envelope on more effective means of screening," Hightower says. Brenner notes that it would be premature to say whether the Think Before You Pink campaign has made any inroads in how fund-raising efforts are tracked. But she notes that the media coverage has become a "double-edged sword" for companies, which will come under greater scrutiny as more news outlets mention the Think Before You Pink website as a resource on breast cancer. Rebecca Farmer, the communications officer for Breast Cancer Action, notes that she has a Google alert set for articles that mention breast cancer and its awareness month. "So many of them are written by a fashion editor," she says. But Think Before You Pink is as much a grassroots internet and e-mail campaign as a media relations one, Brenner notes. "Our experience is that every change that has happened in breast cancer - and I mean every change - came because the people affected demanded it."