Susan G. Komen is the largest breast cancer organization worldwide. The organization is known for high funding researchers related to breast cancer compared to all other nonprofit organizations globally. Apart from funding, the organization also provide real-time help to the people experience the condition. Braun (2003) says that “t he organization was founded in 1982 by Nancy G. Brinker, sister to Susan G. Komen”. Susan Komen lost her life to breast cancer. Nancy promised her sister that she would fight to end the disease after her death. Since then the organization boasts of funding researchers on breast cancer to a tune of above $800 million. It has also funded education, screening, treatment, and psychosocial programs that help millions of people across the globe to a tune of over $1.6 billion
The organization has partnered with more than 50 countries. It also has about 100000 volunteers. These volunteers work in a network of 124 affiliates globally. Despite the fact the organization was once among the most respected ones in the United States, it has lost the position because of various factors. The organization started losing its position in 2012 when it decided to stop the funding program for Planned Parenthood. The organization has also been under serious criticism for the executive pay rises, costs related to administration, and association with particular sponsors.
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Purpose of Susan G. Komen
In reference to Profile, N. E. O. P. L. A. S. I. A., (1999) the organization purpose can be explained by their vision, mission, and goals. The organization vision is to achieve a world without breast cancer or very few cases of the condition. Its mission is to save lives by meeting the most vital needs of the world. Also to invest in researches that sees to prevent and cure breast cancer globally. The organization goal is to reduce deaths as a result of breast cancer by 50% by the year 2026 in the United States.
Target Population
The organization priority audience is women, especially those between the ages of 18 and 60 years. The organization concentrates mostly on the older women because of the fact that they are more prone to develop breast cancer. Selleck, (2010) “despite the fact, that the organization for a long time has concentrated on women between the ages of 35 and 60 years, research has indicated that even younger women are affected too.” Additionally, Komen organization has put more effort on women in the minority groups who are affected by economic conditions.
Size, Geographic and territorial mandate
Susan G. Komen organization has affiliates not only in the United States but across the globe. In the United States alone the organization has affiliates in over 100 cities with tens of thousands volunteers. As mentioned before, the organization also operates in more than 50 countries globally through the help of over 100,000 volunteers. Most of the Komen organization volunteers are individuals who have been touched by the fight their loved ones have shown against breast cancer. These volunteers play an important role in raising awareness about the condition, push for local improvement in services and programs design towards curbing breast cancer and raising funds.
Funding sources
Komen organization has various approaches to obtaining funding – cause marketing, events, corporate partners, and mobile fundraising. The organization raises over $35 million from cause marketing partnerships (Bernstein, 2017). Cause marketing also creates a platform for creating awareness. Bernstein (2017) says that the organization has a wide range of events that help raise funds – Susan G. Komen Race for Cure, Susan G. Komen 3-Day for the Cure, Susan G. Komen passionately Pin for Cure, Susan G. Komen Bowl for the Cure (Harvey & Strahilevitz, 2009: Selleck, 2010). Some of the corporate companies that have partnered with the organization through funding include American Airlines, Bank of America, Ford Motor Company, Baker Hughes, Hewlett-Packard, WWE, Hopkins manufacturing, General Mills, and Cal-Maine Food, Inc. among many others.
Need For Change
As depicted in chapter one Susan G. Komen is the leading non-profitable society that is devoted to saving lives of people suffering from breast cancer by funding for their treatment. Distant from funding, the Susan G. Komen organization provides a real-time assistance to the people with cancer during and after the treatment (Lee , Lee ., Avraham , & Avraham, 2014) . This kind of help includes counseling, spiritual and emotional support to the patients recovering from breast cancer. The organization is currently operating in more than 50 countries globally with over 100,000 volunteers who are willing to help.
With the accumulation of the number of people who were willing to volunteer, Komen sought out a way to engage with the whole world by creating a breast cancer community online site. The organization’s vision is to achieve a world without breast cancer the online site was anticipated to spread awareness of breast cancer to all women globally (van Golen , Bao , DiVito , & Wu , 2012) . As stipulated by the organization mission of saving lives of women faced with breast cancer the online platform was meant to raise funds which would come from the willing volunteers.
Apart from the online site Komen organization has various means to obtaining funding like corporate partners, marketing, mobile fundraising, and some cancer awareness events. The organization rises over $35 million from marketing partnerships. Cause marketing also generates a platform for creating awareness. The organization has a wide range of events that help raise funds for Susan G. Komen organization. Some of the corporate organizations that have united with the organization through funding include Bank of America, American Airlines, Baker Hughes, Hewlett-Packard, WWE, Ford Motor Company, General Mills, and Hopkins manufacturing (Nunes , Schnall , & Orel, 2013) . From all this cooperates organizations Komen raised a lot of money to help with those suffering from breast cancer.
With the initial intention of Komen organization of raising awareness so that volunteers would donate money, resources and time to aid breast cancer patients. After the money was raised the Komen organization reformed their money used for the good case but used the money for no non-profitable case for the breast cancer patients (Burstein , Tsimelzon , Poage , & Covi, 2014) . The fact still remains that the money was not used for a good case as it was planned by the organization.
From a report from Charity Navigators, the money that was donated of about $ 500,000 only 20.9% of the donated funds was sent to aid patients with breast cancer. Negative publicity drew attention as to how the organization was allocating and spending its money. The following complaints were raised; (1) why they were a comparatively small percentage of the donated money going the medical research for the cure of breast cancer; (2) why they were enormous legal expenditures incurred from using the Komen organization for the cure of cancer. (3) Why it was a political issue for making women with breast cancer cure. (3) Why they were a high salary payment for the founder and the organization board members (Burstein , Tsimelzon , Poage , & Covi, 2014) . Despite the above-mentioned allegations by the public, Susan G. Komen did not respond to them, as a result, the public was angered with the functioning and operation of the non-profitable organization.
Komen came up with a policy of parenthood which was not happily welcomed by these corporate sponsors who claimed that they were not informed about the change. While none of the affected corporates abandoned the organization publically as a result of the organization controversy, they requested the organization to make better communication before coming up with a policy (Lee , Lee ., Avraham , & Avraham, 2014) .
The main need of change was about how the funds were allocated and the spending of the money. This was as a result of the money not going to help in the diminishing of breast cancer but rather going to pay salaries and too much-donated funds spent on events.
From the agenda stipulated by Susan G. Komen the following were the anticipated results; (1) guarding the federal funding for the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) wherein the agenda it was to ensure all women are able to access breast cancer screening to help them know if they have breast cancer or not. (2) Necessitating permit of insurance companies to deliver coverage for oral-cancer drugs which was foreseen to be cheap and the patient who afford it. (3) Safeguarding continued federal stocking in biomedical inquiry through the National Institutes of Health (NIH) (van Golen , Bao , DiVito , & Wu , 2012) .
Unfortunately for Susan G. Komen, the anticipated result did not come to accomplishment due to the non-profitable usage of the money. From an economic perspective, the nonprofit organization uses its donated revenue to invest in accomplishing their goals, vision, and mission and rather not to distribute the surplus revenue income to be shared by the stakeholders of the organization. But in our case, after thousands of volunteers willingly donated their revenue to fight and try to mitigate breast cancer the Susan G. Komen organization used the revenue to pay stakeholders and employees’ salaries and allocated some money to cater for their events (Sherman , Figueroa , & Henry, 2014) .
Cause of the Problems
Being among the leading breast cancer body in the universe, Susan G. Komen organization has been funding, sponsoring and even supporting researchers in the field of breast cancer. Typically, just like any other non-profit organization, Susan G. Komen is not spared, the organization has had its fair share of this problems. Consequentially, the organization’s overwhelming good reputation that had been built over the years has just been can vanish in a single day. In an attempt to discover what the causes of these problems were, it is realizable that the cause of these problems was not only purely on financial aspects (Ryan, 2018). Significantly, these causes were majorly administrative, political, and structural. The exodus of Susan G. Komen organization's problems commenced primarily when the organization made the controversial decisions that cost the organization’s prestige, financial support, and trust.
Significantly, in the year 2016 reports, Susan G. Komen organization reported having received over $257,895,950 in donations from the public and sponsorship and other organizations (Cardoso et al., 2016). The aim was to support the organization’s mission of fighting against breast cancer. After this reports, controversies became the order of the day in the organization. Reportedly, Susan G. Komen organization uses approximately about 20% of its funds to fight against breast cancer. This situation has raised eyebrows as a quick calculation reveals that almost over 80% of the funds are being diverted to other projects that do not necessarily produce breast cancer cure. Another blunder came about when the organization opted to fund pharmaceuticals and other drug research companies, conversely, the drug manufactured may be patented and sold expensively to the very people the organization seeks to protect (Cardoso et al., 2016). That organization has significantly and extensive been fighting other nonprofit organizations who intend to use the phrase “for the cure” in their campaigns against breast cancer. This has been epitomized through several legal actions in courts of law against the small organizations claiming that it will cause donor confusions (Bassett, 2010). Interestingly, the organization also partnered with KFC in selling pink chicken buckets branded “for the cure” however such fast food products are the culprits in causing cancer cells and obesity. In the same breath, the organization also diverted its funds into the production of an aromatic fragrance named ‘promise me.' However, later the perfume was discovered to be toxic and contained cancer-causing ingredients.
Concerning the financial decisions further, it is notable that in 2012 alone the organization's founder Ms. Brinker was given an over 60% salary increase. She was to receive approximately $684,000 despite the challenges in the organization’s financial kitty as the funding and donations had dropped (McDonnell et al., 2017). In response to this decision, the organization administrative arm came out with deceit to defend themselves. In the same breathe, the organization has resorted to using and diverting the organization’s funds to advertise, promote and provide mammograms to women in an attempt to save lives. However, interestingly, statistics reveal that this practice is purely misdiagnosing and over-treating the women as basically, mammograms do not save lives (Hunt et al., 2017). This unfortunate decision within the organization has resulted in harmful impacts that subject victims to unnecessary surgeries, the dreaded chemotherapy medication, and radiotherapies. Significantly, it is evident that Susan G Komen organization had previously also entered a joint venture with real water company with intend of producing Pink water bottles . This was plastic bottles disposable. However, it was discovered that the organization is still shooting its own feet. The disposable bottles contained BPA substances that are firmly related breast cancer-causing organisms.
The poor administrative structure decided to venture with Baker Hughes Company in production of pink drill bits used for fracking, interestingly, the fracking process itself uses chemicals such as formalin, and these chemicals are primary causes of cancer. Susan G. organization initiated the Planned Parenthood (Goodman, 2016) . This plan had nothing to achieve in fighting breast cancer. In the same breath, this program was also founded by Margaret Sanger; a well-known proponent of sterilization, a racist, and eugenicist who supports abortion in America. When controversies arose, Komen organization came out and stated that it had stopped funding Planned Parenthood pending federal government investigation. However, Komen organization reverses their position and continued funding this program. In general, Susan G. Komen organization broke its promise, mission, and dedication towards fighting breast cancer (Goodman, 2016) . Funding Planned Parenthood implied that the organization’s principles do not support abortion agenda instead they favor anti-cancer campaign.
It is also evident that the leadership structure in Komen organization has lost its way. The organization has adamantly become more self-promotion, pursuing self-interests and self-preservation other than dedicating itself to the mission and vision of the organization (Bassett, 2010). This situation I have been epitomized in the organization's demeanor. It has refused to acknowledge the effects of chemical BPA cancer relation even after scientific discoveries establishing that the chemicals cause cancer tumors. The organization has insisted on using the same chemicals presumably because most of their donors always manufacture a product that fundamentally relies on BPA chemicals. The administration and leadership of Komen organization are not stable, there has been an exodus of staff departures, and funds are being lost through misappropriation and mismanagement. Reports show that New York and Oregon affiliates' leaders had stepped down and resigned when the Planned Parenthood controversy came. This is just but an indicator that there is no harmony in the organization's administration and leadership structure. More tribulation has also been encountered especially the grant on Planned Parenthood debate came to erupt in public and the misleading information on the benefits of mammograms treatment.
Politically, this problem initially seemed harmless. However, it has led to massive loss of the organization's reputation. Interestingly, Komen organization has taken that political side is claiming to political, however, the then CEO Ms. Brinker was a Republican. In this lane, Ms. Brinker identifying herself well with the Republicans ultimately donates large shares of the organization's funds not only to Republican candidates venturing into politics but also other notable figures in America (Valcik et al., 2015) . Fundamentally, when Karen Handel took over the leadership of the organization, there was no difference (Thomas , 2013). This was a continuation of political inclination .
In conclusion , it is arguably to state that the causes in Susan G. Komen organization were related to financial aspects. However, this may not be the sole cause of problems in any typical organization. In the same breath, in Komen’s organization, the issues were not entirely caused by the financial reasons. It is notable that significantly, these causes majorly revolved around administrative, political, and structural aspects. The system of administration was poorly structured. This situation implies that the organization is prone to making poor and problematic decisions. Secondly, the structure of the organization is not clear. There is also significant misappropriation, misuse and diverting of the organization's funds. This is a situation that is a cause of all the organization’s problems. Politically, there are also uncountable problems that resulted from the organization's political inclinations. In any organizational setup, political bent implies favoritism of one political side while discrimination the other hand. This is very causes of the problems the organization is facing now. Suggestively, Komen’s organization should focus on its mission and vision; that is, diligently fighting breast cancer and stop politicking, denial of science, defensive marketing, and focusing on restructuring its administrative arm.
Recommendations for Change
Although there has been a remarkable increase in the rate of understanding and managing breast cancer in the past through Susan G. Komen organization, the disease remains a major public health challenge around the globe. The cancer survivors around the United States currently are estimated to be more than two million, but the number seems to illustrate the progress that has been made against breast cancer. As outlined by Susan Rosiles, before the formation of the Susan G Komen breast cancer movement around 1982, being diagnosed by the disease was seen by many as a death sentence. "If we had known many years ago what we know today about breast cancer, my oldest sister might still be here with us” (Susan G Komen, 2018). However, Komen organization needs to focus more on its mission and vision of combating breast cancer by restructuring its administrative structures and making proper decisions on funds allocation as well as expenses.
As a source of information on issues that relate to breast health and breast cancer for all individuals across the globe, Susan G Komen should only focus on funding educational projects that produce reports and materials that align with its mission and vision “We’re probably the only breast cancer organization that believes that we need to raise money to support research and to support the community” (Kanani, 2011). The Komen’s aims should include, making awareness on breast issues, the threats involved with breast health, individual awareness on wellbeing, the procedure of screening and choices for a healthy lifestyle. The use of consistency and repeated same strategy could lessen confusion, improve maintenance and guide towards acceptance of actions that are believed to be essential for excellence breast care.
Komen organization should prioritize on important funding programs that reduce financial obstacles related to receiving breast cancer services such as screening, diagnostics as well as treatment for underprivileged persons who are not insured or under-insured. This is regarding their statement “We have fought for access to care for the poor and uninsured; funded the clinics that educate, screen and treat people with breast cancer” (Kanani, 2011). The affiliates should seek to finance programs that give low or no expenses to breast cancer services and supporting fund aid with diagnostic and management. Another priority would be navigation programs for patients that would involve a trained person on breast health, to guide patients through and about obstacles that are experienced within the breast cancer care organization. The main focus of patient navigator will be responsibilities based on coordinating and enhancing timely access to analytic and treatment facilities.
Komen’s organization should outline a grant strategy, which would include a research and training grants that would be provided in support of a research procedure presented in a grant application “grant will enable us to extend our life-saving treatment services to more women” (Brinker, 2018). In the grant application there needs to be the inclusion of approved modifications for funding by Susan G. Komen for a cure. Through policies and procedures, specific terms and conditions for application to a Grant should be set forth by Komen as might be modified from a point in time. An administrative officer should do the signing of grant agreement on behalf of the grantee institution, who possess signatory right and should also be signed by the principal investigator (PI) or associate if the grant is aimed for postdoctoral society. If the grant is for postdoctoral society, the signing should be done by any co-principle investigator (Co-PI) and the postdoctoral mentor (Mentor).
In the instance of various Grantee organizations or involvement of several PIs or Co-PIs, all orientations to Grantee institution will submit jointly to all the organizations involved, all situations to PI of Co-PI will submit jointly to all chief investigators and co-principle researchers concerned. In the same case, all orientations to Grantee will present collectively to all PIs, Co-PIs, Mentor and Grantee organization concerned. In the Komen grant mechanism, there needs to be unique characteristic in each, which include duration, level of funding, recipient descriptions, eligibility necessities, project obligation, and acceptable budget distribution. These features and necessities should be detailed in the Request for Application (RFA) with the grant mechanism incorporated by orientation into the outlined guidelines and procedures.
The Komen Grants need to be managed through a central computer, with a management software system that includes all active research and training plan grants. The earlier management system is known as Komen Grants Management System (KGMS), acts as an information storage area for all grants given before the completion of Komen's switch to PC. Authorization to use the PC would be given to Grantee that recognizes the Komen’s notification of intention to finance, whether specific or conditional, PI or Co-PI, and any Mentor (Susan G. Komen, 2013). Upon notification to Komen, additional users might be allowed to access the PC with previous to the approval of the ASO or PI.
Before execution of a grant agreement, all Komen aided grants should be updated in compliance with all Komen necessities. Submission of particular financial data, application statistics, and regulatory credentials are required for submission to Komen before the effecting of an agreement for a grant. The required documents should be requested and approved by Komen through PC and are uploaded to the PC within a thirty day period unless an extension period is given by Komen (Susan G.Komen, 2015). The grantees that receive finances from other sources might not receive funding due to overlapping of funds for the same research or training practices. Applicants need to list all other research aids, consisting of project title, aims, funding quantity, period and funder. Overlap possibility is reviewed before awarding of grant and is examined annually all through the period of every donation.
Until Komen implements grant agreement, no expenses could be accumulated against the grant and Komen would not compensate any costs acquired before the effectual date of the agreement on the grant. The effective period of grant accord is the time on which Komen signs the funding accord. The applicant could request a delay in the start time of the grant for up to six months after the time that Komen gives its notice in the intention to finance the applicant. The requests for delay should be sent fourteen days from the date of notification with detailed cause for delay and the expected start date for the grant.
Since the PI, Co-PI and Mentor of grantee organizations are under the scope and regulation of the grantee organization policies, Komen does not take responsibility for the performance of a research plan or their activities. Komen, however, needs the applicants to disclose at the date of submission whether human material, human organic/anatomical subjects, animals subjects or genetically made mechanisms would be utilized in the planned research. The information also includes a guarantee that the occasion the grant is awarded will be executed with the necessary protection in the employ of human subjects.
Komen should annually review the format and content necessities for scientific progress of grant as well as final research reports and could modify the progress at any point in time. Email notifications would be provided by Komen to grantees on any changes in the reporting necessities before reporting dates. Grantees are accountable for evaluation and conform with all reporting necessities in effect to the time of delivering the reports. Annual scientific progress is required to be submitted by grantees detailing the research progress, disputes and their cure, research conclusion and inventions taking place at the reporting time.
There needs to be a requirement for a grantee to submit annual monetary reports that summarize the expenditure in the period of reporting (Martinez, 2015). Reporting of all expenditures need to be in United States dollars. In case of grantee want to move funds across budget types in excess of the limits allowed, the grantee must submit a request for budget change form in PC. The annual reports should be done not later than thirty days after each centenary of the grant start time for the period of the grant tenure. This should be done except for the last year of the grant when a concluding monetary report is to be delivered. The date of reporting of the annual monetary report should be set thirty days after the supposed time for the progress statement. This would permit a period for the compilation of financial information to make sure that the detailed expenses reflect full twelve-month progress. The financial report should include the awarded budget, current year budget, expenditure, justification for the expenditure and signature affirmations.
Other reports and engagements could be needed with reasonable notice to the grantee, which could also need the grantee to participate in site visiting, phone conferences, displays or other speaking arrangements and activities. Komen, in such instances, should use good faith attempts to contain the grantee's schedule variance. As applicable, in arranging any travel measures or meetings, a Komen grant officer will aid the PI, Co-PI, and mentor as required. Reports on scientific advancement, monetary, and concluding research are not measured as confidential, and Komen could contract third parties who may possess the essential expertise to analyze the reports and assess the development of the plan. The information could also be shared with donors who would have provided monetary aid for Komen studies “We are maintaining the integrity of who we are and what we hold sacred, and that is integrity, honesty, trying very hard to deliver what we have promised” (Brinker, 2018). For any damages caused by the disclosure of the reports content to third parties, Komen would not be responsible. For restricted cases where data provided in a statement must be kept secret, grantees must contact their Komen managers, and there should be clear marking as confidential.
A grantee, upon the written authorization of Komen, could subcontract a third party to help with the mission by instituting an association or subcontract accord where the research would be done by the grantee and one or more other institutions that possess separate legal units (Chadwell et al. 2015). The grantee, in these pact contracts for the presentation of segment activities to be carried out under the grant. These accords involve a particular part of an effort from the association or subcontracting institution's main investigator and a definite outline of costs, comprising all budget areas of the original grant. The budget of all subcontracting and associations should be presented together with the monetary report by the grantee. Associations and subcontracts are answerable and should abide by the grant accord, which involved strategies and procedures outlined between Komen and grantee, with grantee possessing the responsibility of ensuring compliance.
Approved equipment cannot cost more than thirty percent of the entire direct cost and are to be used during the period of Komen funded project and should be used on the PI, Co-PI, Mentor and any associates (Susan G. Komen, 2012). The grantee organization conducting the plan should vest the title of the equipment; however, in the occasion of an approved transfer of the grant to another organization, equipment could be transferred to the new institution with a written endorsement from Komen. In the completion of the plans, the entire equipment acquired in the course of the Komen-aided project should remain at the grantee organization.
All grant finances should be utilized according to the project’s permitted budget. The first year budgeted funds should be given out by Komen within thirty days of the start time of the grant. Komen will distribute the hundred percent of the planned finances in the final year of the grant period after assessment and endorsement of satisfaction on the timely scientific report advancement (Susan G. Komen, 2018). Komen, as part of its oversight on the research advancement, could adjust the time of project reporting together with the associated distribution of grant finances at any stage in the course of the grant period with a written communication to the grantee.
Transmission of all grant payments should be done through Automated Clearing House (ACH) transfer to grantee organization’s account at its monetary foundation, except when otherwise appealed in writing. The responsibility of providing Komen with the correct and complete ACH data lies with grantee organization as part of the submission of needed documents prior to signing the grant accord (Susan G. Komen, 2012). In cases where grant mechanism permits insertion of indirect expenses, the costs should not go beyond twenty-five percent of the entire direct expenses of the grant all through the existence of the grant. Indirect expenses are all expenditures not related directly to the performance of the plan, comprising allocated expenses like utilities and rent. Associates, as well as subcontractor affiliates, might not use and finances to compensate indirect costs in more than twenty-five percent of their entire direct expenses.
The responsibility of Komen will not be observed in any expenditure done after the expired period of the grant nor will be the expenses that are not allowed as outlined within RFA or any spending that is conflicting with the agreed research project and financial plan that is more than the entire sum of the grant. No individual employee of the project would have base earnings exceeding US$250,000 annually (Susan G. Komen, 2012). Komen and its selected associates should have the rights to request and receive copies of any documents and other data linked to the grant at any stage in or after a period of the grant. The requests should be made and received from grantee organization, PI, Co-PI as well as a mentor not forgetting mentors involved in any subcontractor association. The rights comprise and not restricted to, evaluation of all monetary books and reports linked to the grant as well as performing an assessment or other accounting processes of entire expenditures associated to grant directly or indirectly.
All changes in the grant standing unless outlined explicitly in the guidelines and procedures should be put forward for endorsement by Komen using the suitable change appeal form and the templates for delivery found on the PC. Komen, depending on the requested change could send a grant accord amendment to the grantee for signing. After execution by the grantee, Komen should sign and return a wholly executed copy of the adjustment to the grantee and upload a copy of the modification to the PC (Carbone et al., 2015). In the case of funds, grantees should be given restrictions on the movement of finances across budget areas to meet outlined research requirements. The grantee could make request for permission to accelerate funding of the grant. Meaning grantee could request for re-budgeting of financial allocation into an earlier period. There should be no cost extensions, meaning, amending the grant accord by changing the time of concluding, duration of the agreement is extended without providing additional finances.
In the urge for the Susan G. Komen organization to change on its spending allocation, the grantee should be advised on the main priority that should be researched for improvement of access to breast cancer care. In enhancing access to and utilization of breast care plans, these could impact incidents of breast cancer and survival. Strategies for strengthening reasonable access to breast cancer management should be modified to meet the requirements of the desired persons. In identifying and addressing obstacles, cancer survivors, healthcare personnel, and advocates should be engaged.
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