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October is Breast Cancer Awareness Month, a time dedicated to education, early detection and creating change for those affected by the disease.

In prepration for the 1893 Chicago World’s Fair, a Minnesota Women’s Auxiliary Board was put together to create a design. They hosted a contest and from 200 submissions, local artist Amelia Hyde Center designed the winning flag.

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“The pink ribbon symbol is not regulated by any agency, and its use does not necessarily mean the associated product effectively raises funds for breast cancer or works to stop breast cancer at all.

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It was embroidered by Pauline and Thomane Fjelde, sisters who won a gold medal for their work. The flag was officially adopted April 4, 1893.

Keep reading to learn about the history of pink ribbons, plus why their meaning may differ from one organization to the next.

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This behavior is called "pinkwashing, a term coined by the Breast Cancer Action in 2002. Pinkwashing is defined as "a company or organization that claims to care about breast cancer by promoting a pink ribbon product, but at the same time produces, manufactures and/or sells products containing chemicals that are linked to the disease."

The star is a regular octagram, constructed from 8 vertices arranged equally around a circle. Each vertex is connected to the vertex that is 3 turns away.

“To me, the history of the pink ribbon is an incredible testament to how people have united over the years to impact real change,” Paula Schneider, president and CEO of Susan G. Komen, told TODAY. “The ribbon symbolizes so much more than a handout at an event, but a promise and a vision to end breast cancer for good as a unified community."

Of course, the majority of people use the pink ribbon to promote a good cause. Still, it's important to keep in mind that some people peddling pink ribbons aren’t affiliated with a credible organization.

“Komen gave out similar pink ribbons to every participant in its New York City Race for the Cure®. This was truly the first use of the pink ribbon, but its evolution was just beginning,” Schneider said.

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The Minnesota flag features a concave pentagon of deep blue at the hoist charged with an eight-point white star. The remainder is solid, bright blue.

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Many say it all started with Charlotte Haley, the granddaughter, sister and mother of women who had been diagnosed with breast cancer. In 1991, Liz Smith wrote a story for Self magazine chronicling how Haley began making peach-colored ribbons for breast cancer awareness. With each set of ribbons she made, she included a card that read: “The National Cancer Institute annual budget is $1.8 billion, only 5 percent goes for cancer prevention. Help us wake up our legislators and America by wearing this ribbon,” per Breast Cancer Action.

“Charlotte Haley was truly a grassroots activist and advocate. She called for policy change from legislators and for more funding for breast cancer prevention,” Tibby Reas Hinderlie, communications manager at Breast Cancer Action, told TODAY.

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There are lots of pink ribbons on the market these days. Any generic pink ribbon symbolizes breast cancer awareness, while the “running ribbon” is reserved solely for Susan G. Komen.

“The running ribbon came about in 2007, when the Susan G. Komen Breast Cancer Foundation changed its name to Susan G. Komen for the Cure, and the name change was accompanied by a new brand image,” Schneider said. They added a pink ribbon to the new logo to "signify the promise Komen founder Nancy G. Brinker made to her dying sister, Susan G. Komen, to end breast cancer forever.”

Shortly after, Alexandra Penney, the editor-in-chief of Self, wanted the publication’s second annual Breast Cancer Awareness Month issue to stand out in a big way. “She created a ribbon and enlisted the cosmetics giants to distribute them in New York City stores," Schneider said. "The pink ribbon really took off and other organizations began to adopt the symbol as well.”

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Whether emblazoned on a t-shirt or clipped onto a bag, pink ribbons are everywhere come October. Since the annual campaign is around the corner, it’s a fitting moment to better understand why — and how — pink ribbons have become the now-ubiquitous symbol for breast cancer awareness.

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But Susan G. Komen, then known as the Susan G. Komen Breast Cancer Foundation, helped pink ribbons go mainstream. Although the foundation had been handing out bright pink visors to breast cancer survivors running in its Race for the Cure since late 1990, they adopted pink ribbons in a fall 1991 — just a few months after Irons' appearance at the Tony Awards.

In the early 1970s, Irwin Levine and L. Russell Brown penned “Tie a Yellow Ribbon Round the Ole Oak Tree." The song inspired Penne Laingen, the wife of a hostage in Iran, to tie yellow ribbons around trees to bring attention to the national crisis — and ultimately, bring her husband home. “This was truly the first time ribbons became passion and power, and they started popping up all across the country as people came together over a cause,” Schneider said.

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Breast Cancer Action is committed to stopping pinkwashing in its tracks. "We need more than awareness — to address and end the breast cancer crisis we need action," Reas Hinderlie told TODAY, emphasizing that Breast Cancer Action challenges corporations, nonprofits, government leaders, and regulatory agencies that use pink ribbons and empty awareness to distract from the systemic issues at the core of this crisis.

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In the 2001 North American Vexillological Association (NAVA) flag survey of United States and Canada flags, the flag of Minnesota was ranked 67th* out of 72.*The flag voted on was the 1983-2024 version (see Previous Iterations section).

As Schneider puts it, the pink ribbon is actually a moving piece of American history “tied to the overall sentiment of unity and support.”

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This lack of accountability and transparency can create more problems, exploiting the goodwill of those that want to stop this disease, misrepresent anyone who is affected by breast cancer and marginalize diverse lived experiences of the disease. “Sometimes, pink ribbon products have even been linked to increased breast cancer risk, which is why we encourage those who want to address and end the breast cancer crisis to be critical consumers of pink ribbon products and breast cancer fundraisers,” she said.

Awareness ribbons eventually got the star-studded treatment at the Tony Awards in 1991. “AIDS activists turned the ribbon bright red, looped it and pinned to the chest of actor Jeremy Irons. People really went wild over it — the 1991 equivalent of ‘going viral,’ if you will," she added.

“The pink ribbon symbol is not regulated by any agency, and its use does not necessarily mean the associated product effectively raises funds for breast cancer or works to stop breast cancer at all," Reas Hinderlie said.

In 2023, Minnesota formed the State Emblems Redesign Commission and began accepting public submissions. The chosen flag, a modified design by Andrew Prekker, was adopted May 11, 2024.