as the sole possible approach to public health for breast cancer. alternatives, such as pollution prevention, are largely ignored. as the majority of women with breast cancer have no risk factors other than sex and age, the environmental breast cancer movement suspects pollution as a significant cause, possibly from pesticides, plastics, and industrial runoff in ground water. large organizations, such as susan g. komen for the cure and the american cancer society, are not part of the environmental breast cancer movement. these large organizations benefit the most from corporate sponsorships that critics deride as pinkwashing, e.g., polluting industries trying to buy public goodwill by publishing advertisements emblazoned with pink ribbons, rather than stopping their pollution under the precautionary principle. the non-genetic factors with consistent evidence increasing breast cancer risk include "ionizing radiation, combination estrogen–progestin hormone therapy, and greater postmenopausal weight. ... for many other factors, the evidence from human studies is more limited, contradictory, or absent" and called for additional research. conducting research into whether a chemical causes cancer is difficult, because "suspect chemicals cannot ethically be given to people to see if they cause cancer. people exposed in the past can be studied, but information about the dose and timing may be sketchy. animal studies can provide useful information, but do not always apply to humans. and people are often exposed to mixtures of chemicals that may interact in complex ways, with effects that may also vary depending on an individual's genetic makeup". samantha king says that prevention research is minimized by the breast cancer industry because there is no way to make money off of cases of breast cancer that do not happen, whereas a mammography imaging system that finds more possible cancers, or a "magic bullet" that kills confirmed cancers, would be highly profitable. breast cancer action breast cancer action is an american grassroots education and advocacy organization that promotes breast cancer awareness and public health issues relating to breast cancer, and advocates for system-wide change based on prevention. breast cancer action is also known for its think before you pink campaign, launched in 2002, which encourages consumers to ask critical questions before buying pink ribbon products. dissent through art while the pink ribbon culture is dominant, there are alternatives. the environmental breast cancer movement is one type of dissent. another is the rejection of compliant optimism, aesthetic normalization, and social pleasingness that the pink ribbon culture promotes. in 1998, the art.rage.us art collective published a book that collected some of the art work from their traveling collection. this included art that was shocking, painful and realistic rather than beautiful, such as several self-portraits that showed mastectomy scars. another art form has a wider range: the illness narrative has become a staple of breast cancer literature and is prominent in women's magazines. this may take the form of a restitution or cure narrative (the protagonist seeks a physical or spiritual return to a pre-diagnosis life), a quest narrative (the protagonist must meet a goal before dying), or a chaos narrative (the situation inexorably goes from bad to worse). the cure and quest narratives fit neatly with the breast cancer culture. chaos narratives, which are rarer in stories about breast cancer, oppose it. history william stewart halsted, responsible for the radical mastectomy that dramatically reduced death rates due to breast cancer, but later proved to be controversial in its own right. breast cancer has been known since ancient times. with no reliable treatments, and with surgical outcomes often fatal, women tended to conceal the possibility of breast cancer as long as possible. with the dramatic improvement in survival rates at the end of the 19th century—the radical mastectomy promoted by william stewart halsted raised long-term survival rates from 10% to 50%—efforts to educate women about the importance of early detection and prompt action were begun. early campaigns included the "women's field army", run by the american society for the control of cancer (the forerunner of the american cancer society) during the 1930s and 1940s. explicitly using a military metaphor, they promoted early detection and prompt medical intervention as every woman's duty in the war on cancer. in 1952, the first peer-to-peer support group, called reach to recovery, was formed. later taken over by the american cancer society, it provided post-mastectomy, in-hospital visits from women who had survived breast cancer, who shared their own experiences, practical advice, and emotional support, but never medical information. this was the first program designed to promote restoration of a feminine appearance, e.g., through providing breast prostheses, as a goal. organizations a wide variety of charitable organizations are involved in breast cancer awareness and support. these organizations do everything from providing practical support, to educating the public, to dispensing millions of dollars for research and treatment. thousands of small breast cancer organizations exist. the largest and most prominent are: susan g. komen for the cure: komen is the largest and best funded organization, with highly visible fundraisers. national breast cancer coalition: this large umbrella organization played key roles in several prominent pieces of american legislation, such as the creation of the united states department of defense's breast cancer research program, genetic non-discrimination laws, and the patients' bill of rights. they are committed to evidence-based medicine. breast cancer action: famous for its "think before you pink" campaign against pinkwashing, bca emphasizes the need for research into pollution as a cause of breast cancer. like the national women's health network, they refuse funding from any group that may have a conflict of interest, such as pharmaceutical companies, medical imaging companies, or pollution-causing industries. national breast cancer organization: closed in 2004. a dissenter to the notion of mandatory public unity, it provided case management and other services.