These days, it's hard to miss the pink ribbons. They are on packages everywhere, from Lean Cuisines to Dirt Devils to Energizer batteries – a symbol for the fight against breast cancer.

And to find the main source behind the "pinking of America," look no further than the Dallas-based Susan G. Komen Breast Cancer Foundation, said Trent Stamp, president and executive director of the watchdog agency Charity Navigator.

"I swear to God someone just offered me a pink bagel," he said. "... It's an overwhelming movement."

And an extremely successful one.

What began with one 800-participant race in Dallas in 1983 now attracts 1.3 million worldwide each year, including 25,000 expected at the Dallas affiliate's 24th annual Race for the Cure on Saturday. The organization's $200 start-up budget in 1982 now surpasses $200 million.

And the practice of handing out pink ribbons at one race has grown into a mass-marketing phenomenon.

The foundation is the nation's best-known breast cancer charity, the largest nongovernmental source of funding for breast cancer research and a pioneer in marketing for a cause, with a parade of pink ribbon promotions during the current National Breast Cancer Awareness Month.

"Everybody associates the pink ribbon with breast cancer awareness and breast cancer research," said Dan Howard, chairman of the marketing department at Southern Methodist University. "This shows you how incredibly successful they have been with that. You've even got pink M&Ms and pink Campbell's soup."

The Komen foundation was one of the earlier groups to use a brightly colored ribbon to raise awareness for a cause, after the yellow ribbons used during the Iranian hostage crisis in 1979-81 and red for AIDS activists the next decade. The marketing trend has grown over the years with the Lance Armstrong Foundation selling millions of yellow wristbands for cancer programs and Bono promoting a Red campaign for the Global Fund to fight AIDS in Africa.

Pink ribbons, which Komen started distributing at its race in 1990, now support a variety of breast cancer causes. But not everybody's buying.

The craze has set off a backlash from some activists who believe such campaigns "pinkwash" or diminish the gravity of a disease expected to kill 40,000 women this year.

"People are getting more and more angry about the pink ribbon industry," said Dr. Samantha King, kinesiology and health studies researcher at Queen's University in Ontario and author of the new book Pink Ribbons, Inc. "Some breast cancer survivors feel their experience is being exploited, and that's because death doesn't sell. The campaigns that are corporate-sponsored tend to be overly optimistic and cheerful."

Likewise, the San Francisco nonprofit group Breast Cancer Action urges consumers to "Think Before You Pink," or question where the proceeds from the promotions actually end up.

Nancy Brinker, who created the Komen foundation nearly 25 years ago with funds squirreled away from her grocery money, said the charity sets high standards to ensure that proceeds from such promotions help fund a cure for breast cancer. And she said anyone who thinks the pink ribbon puts a pretty face on the disease does not understand the movement and its history.

"We think it shows a lot of passion," said Ms. Brinker, former U.S. ambassador to Hungary and breast cancer survivor.

Ms. Brinker started the foundation in honor of her sister, Susan G. Komen, who died of breast cancer at age 36. Back in 1982 people would not even say the name of the disease the foundation aimed to fight, she said, and businesses did not want to sponsor a program associated with a life-threatening disease. Ms. Brinker noted that one bra manufacturer's adamant refusal to get involved brought her to tears.

"This was at times gut-wrenching work," she said. "Everybody thought we would fail."

Much has changed since then. The former marketing executive's foundation has helped break through the silence about breast cancer, urged millions of women to get mammograms and taught countless women to perform breast self-examinations. Ms. Brinker, who is still active in the foundation, credits mentors including ex-husband Norman Brinker, who founded the Brinker International restaurant company.

"For a group of women who started out with a disease no one would talk about, and almost everyone saying we couldn't do it, we believe we've changed the world in this way," she said.

The foundation spends 21 cents of every dollar on fundraising and administrative costs, which earns strong ratings from various charity watchdog groups. The Komen foundation ranks among the best breast cancer charities in a survey by Charity Navigator, at www.charitynavigator.org.

Most of the money comes from donations and race entry fees, but corporate deals also make up a large part of the revenue. Pink products raised more than $35 million for the foundation last year.

Ms. Brinker said she is proud of the money raised through marketing products.

"It's always easier to reach people through things that make them feel good, such as clothes and cosmetics," Ms. Brinker said. To cause-related marketing's critics, she says: "You know what, if you can write me a check for $40 million today, we'll talk. Otherwise, I suggest you find something else to criticize because these products really do help."

The revenue and other funds to the Komen foundation have helped pave the way for groundbreaking research, provide mammograms for uninsured women and raise awareness about breast cancer.

Komen officials say all of the attention is making a difference. Less than 30 percent of women had mammograms when the foundation began; now it's over 75 percent. And the federal government gave $25 million a year to breast cancer research when the foundation started; now the number is more than $900 million, according to the foundation.

"We pride ourselves on funding innovative research that might not otherwise get funded," said Hala Moddelmog, the foundation's new chief executive officer, who started last month. "That's where you're going to have the best chance of getting something that's a real leap instead of incremental improvements."

The foundation recently directed money toward new areas, including genetic research into what predisposes a person to have breast cancer and studies that take a harder look at environmental factors, she said.

The nonprofit also works to spread awareness in underserved communities and among men and younger women, still combating myths such as a belief that mammograms will cause breast cancer.

After seeing one professional boxer don pink boxing gloves for a recent match to raise money for another breast cancer charity, Mr. Stamp of Charity Navigator wonders if consumers will become pinked out. "It may have reached the point where it's too much and nobody's going to notice it when everyone's wearing pink," he said.

Dr. Howard, the marketing professor, does not think that's likely as long as the symbol does not get used for other causes.

"There's no danger of oversaturation of the pink ribbon, not any more than there's a danger of an oversaturation of Golden Arches," he said.

At least for now, the pink ribbon isn't going anywhere. Komen foundation officials said they plan to spread the symbol even further around the globe. The agency is still far from its goal of eradicating breast cancer as a life-threatening disease, said Ms. Moddelmog, a breast cancer survivor herself.

"We're all painfully aware that one in eight women are still diagnosed with breast cancer," she said. "It's an epidemic. It's not where it needs to be. That still tells me in general, there's a lot of work to be done."

E-mail khorner@dallasnews.com

WHAT: The Susan G. Komen Breast Cancer Foundation's 24th annual Dallas Race for the Cure, 1K and 5K walk/runs, including a competitive race

WHO: More than 25,000 participants and 1,000 volunteers

WHEN: Saturday (1K, 7:45 a.m.; 5K, 8 a.m.)

WHERE: NorthPark Center (by Macy's)

WHY: To raise money for breast cancer research, education, screening and treatment. In 2005, the local race raised $1.2 million after costs. For more information, go to www.komen-dallas.org or call 214-750-7223.

Start-up budget in 1982

Budget in 2005

Participants in the first race, in 1983

Participants expected Saturday

Participants in Race for the Cure events worldwide in 2005

Number of new invasive cases of breast cancer expected to occur among U.S. women in 2006

The number of women estimated to die of breast cancer in 2006

The number of men diagnosed annually as having breast cancer

The number of men who die of the disease each year

SOURCE: The Susan G. Komen Breast Cancer Foundation