As October comes to an end, we can put away our pink clothes for another year and focus on the real challenge….not awareness but action! I doubt that there is anyone in the United States who does not connect pink with breast cancer and who is not aware that it is a real problem for women. Having just returned from Mexico, I can report that rosa is indeed ubiquitous and that they too are aware! The real questions for those of us working on this problem are: What are we going to do next? What actions are we going to take to make a real difference in eliminating deaths from breast cancer? Screening is ubiquitous; however, we too often conflate finding tumors with saving lives. I wish it were this straightforward, but the reality is that some cancers we find through screening are so fast-growing that our best efforts will be to no avail. And indeed, some are so slow-growing (if they are growing at all), that we don’t need to find them. The thirty percent of women whose cancers are found at a point where we can make a difference in the outcome are important and absolutely worthy of the effort, but what about the others? What about the women who are diagnosed and treated for DCIS when only about a third of them would progress to invasive cancer if left alone? Don’t we owe them something better than removing a normal body part to prevent what may or may not become a life-threatening disease? What about the women with metastatic breast cancer who are living longer, albeit with the collateral damage of treatment and the certain knowledge that their time is limited? Don’t we owe them a cure? It is time to go beyond awareness to finding real answers that will help real women. We need to know WHERE and HOW breast cancer starts. We know it starts in the milk ducts but we don’t yet have a method to map the anatomy of a woman’s ducts! If we had that, we could focus on the duct that goes bad rather than sacrificing the whole breast. We can do this for the lungs and the liver, and we need to do it for the breast. Or even better, we need to know WHY it starts. Could there be a bacteria or virus that triggers the initial mutations that eventually lead to cancer? We know that bacteria cause stomach cancers and viruses cause cancers in the liver and cervix. We need to better understand this organ and whether there may be an infectious cause of breast cancer. We are unlikely to find these answers in mice and rats which have different anatomy and don’t get breast cancer unless we give it to them. We need research on women and men to understand where this disease is coming from, what exposures are stimulating it, and what allows it to spread. Between now and next October, another 40,000 people in the U.S. will die from breast cancer. Let’s declare “Phase One: Awareness” a success and work together to make Phase Two about Action and Answers. Without a concerted effort by everyone—the breast cancer organizations, the government, the scientific community and most importantly, the public—to work together, we will not get to the one goal we all want more than anything else: a future without breast cancer!