For 30 years, the Susan G. Komen Foundation has set the pace and won the race - not for the cure of breast cancer, but for trademarks, sponsors, alliances and clout.
While Komen's power has long inspired mixed emotions among other breast cancer groups, the grassroots remained loyal - at least, until this week, when Komen announced it would stop funding Planned Parenthood's breast cancer screening efforts.
Komen reversed itself on Friday, but only after blistering outrage from legions of people who Race for the Cure or buy pink-ribboned products.
And it still may not be over. Now, Komen is facing ire on a new front: anti-abortion activists who feel the group caved to pressure from the left.
Komen is "clearly in trouble, but they have a loyal fan base and they have been extremely successful at promoting their approach to breast cancer for a long time," said Samantha King, a health sociology professor at Queen's University in Canada and author of Pink Ribbons Inc., a scathing look at breast cancer cause marketing. "I think it's too soon to tell what will happen."
In trying to smooth things over, Komen announced it will continue to give grants to Planned Parenthood's breast health programs, and it will amend its new grant process to disqualify only those applicants who are under an investigation that is "criminal and conclusive in nature and not political." Planned Parenthood is currently under investigation by an anti-abortion Congressman Cliff Stearns, R-Fla.
Komen officials also said they were "distressed" that anyone thought the original funding criteria changes "were done for political reasons or to specifically penalize Planned Parenthood."
Planned Parenthood Federation of America America - which has received about $3 million in pledges since Tuesday, more than four times last year's Komen grants - promptly accepted the olive branch. It said "we are heartened that we can continue to work in partnership" to provide breast screening to poor women.
But if retired nurse Muriel Siegel, 85, of Audubon, PA. is any indication, a lot of women are not so forgiving.
"Today I got a letter from Komen about donating to the 2012 Race for the Cure," Siegel said Friday. "I called them and told them to take my name off the list."
Komen was founded 30 years ago in Dallas by Nancy Brinker, a breast cancer survivor whose sister, Susan G. Komen, did not survive.
As Brinker writes in her memoir, Promise Me, her sister said: "Breast cancer ... it has to change, so women don't die. Promise me, Nanny. Promise me, you'll make it change."
Since then, the foundation has raised more than $1 billion for breast cancer education, detection, care and research.
But Komen has also been faulted by some breast cancer activists for turning the movement into a cuddly, commercialized, cash-laden crusade that is nowhere near curing the disease that annually strikes more than 230,000 American women and kills 40,000 a year.
"If we were to see a shift in Komen's agenda and priorities, that would be a good thing," said King, whose book has been made into a documentary of the same name. (Coincidentally, it premiered Friday in Canada and reaches the U.S. this spring.)
San Francisco-based Breast Cancer Action faults Komen for accepting money from companies whose products may be environmentally linked to breast cancer. Action has skewered Komen in campaigns including "Think Before Your Pink" and "Raise a Stink."
The latter one denounces Promise Me, a perfume Komen commissioned and began selling last April. Action had a sample chemically analyzed (the label doesn't list ingredients) and found galaxolide, a synthetic musk, common in fragrance products that has been found to disrupt estrogen, the female sex hormone, and accumulate in human tissues.
"At the end of the day, we want the same thing: we want to end this breast cancer epidemic," said Breast Cancer Action president Karuna Jaggar. "We just have fundamentally different views of how to do this.
"The model of cancer that Komen promotes is outmoded and oversimplified: that all breast cancer is the same and grows in the same way, and that if we just catch it early enough, it can be cured," Jaggar went on. "In fact, we now know breast cancer is many diseases."
Views and values are at the heart of the brouhaha, believes Steven Balzac, a Stowe, Mass. management consultant and psychology professor who has blogged about the brouhaha.
"Donors thought they had values that matched Komen's values - women's health, eradicating breast cancer, things that transcend petty politics. We're talking about people's lives. What donors suddenly realize is: It's not all about people's lives."