Racing for the Cure

Nancy Brinker divides her life into 13-minute increments. That’s how long it takes breast cancer to kill another woman. 13 minutes. A four-year-old boy loses his mother. 13 minutes. Nine children lose their grandmother. 13 minutes. A college student loses her older sister. For years, Nancy Brinker has been racing to lengthen the intervals. And she won’t stop until they go away forever.

The clock started for Nancy in 1977. Her older sister, Susan, was diagnosed with breast cancer. Susan was a mother of two, a homecoming queen and model. Her diagnosis was not the sort of thing that people felt comfortable talking about. “Promise me it’ll be better,” Susan asked her sister. “Breast cancer—we have to talk about it. It has to change. . . so women know . . . so they won’t die.” “I promise, Suzy. I swear,” Nancy replied. “Even if it takes the rest of my life.” Susan died three years later, at the age of 36.

And so Nancy began the race of a lifetime. In 1982, she founded the Susan G. Komen Breast Cancer Foundation, now known as Susan G. Komen for the Cure (SGK). The organization planned to raise money from sponsors, corporate partners, and signature events and then direct the proceeds to cancer research, advocacy, and prevention. In 1983, it held its first Race for the Cure, in Dallas. A year later, Nancy herself battled breast cancer—and won.

Today, SGK ranks among the world’s largest and best-known cancer charities. In countries around the world, it hosts Race for the Cure 5K runs and walks—over 140 to date. Every year, more than 1.6 million people participate. In the United States, races are organized by local Komen affiliates, and 75 percent of the funds raised from the race go to breast cancer education, screening, treatment, and outreach programs in that community. (The remainder goes to the national organization to support breast cancer research.) In 2010, the Race for the Cure alone raised nearly $180 million. That same year, the national Komen organization spent over $280 million on cancer research, screening, treatment, and education.

As Nancy worked to scale up SGK, she often called on an accomplished entrepreneur: her husband, Norman Brinker. Brinker pioneered casual dining chain restaurants, starting with Steak and Ale in the 1960s. In 1984, Norman took over Chili’s, then a small Texas restaurant chain with a few dozen locations. Before his death in 2009, Brinker had grown it to more than 1,400 locations worldwide. During his lifetime, his firm, Brinker International, was also the parent company of Romano’s Macaroni Grill, Maggiano’s Little Italy, and Corner Bakery; the firm’s income grew to $220 million in 2007.

In 2001, Nancy Brinker left her seat on SGK’s board to serve for two years as Ambassador to Hungary. From 2007 to 2009, she served as Chief of Protocol of the United States, working to ensure the proper diplomatic interaction of American and foreign leaders. Since 2008, she has also served on the board of the John F. Kennedy Center for the Performing Arts. In 2009, she assumed her current post as CEO of Susan G. Komen for the Cure, and President Barack Obama awarded her the Presidential Medal of Freedom.

Philanthropy spoke with Amb. Brinker over tea and cookies at her residence in Georgetown.

PHILANTHROPY: Before we talk about Susan G. Komen for the Cure, can you tell me a little about your business background?

AMB. BRINKER: Of course. I graduated from college and went to live in Dallas, Texas. I was employed by one of very few companies that had executive-track openings for women: Neiman Marcus. I wasn’t particularly interested in clothes and fashion, but I was very interested in marketing. Stanley Marcus—who was the son of the founder, and one of the greatest retailers ever known to mankind—had an enormous influence on me.

PHILANTHROPY: What do you remember most about your time there?

AMB. BRINKER: Mr. Marcus taught me that you always have to create the experience—always tell the customer a story, always make the merchandise look fresh. With him, there was always excitement and drama and high visibility. He was constantly bringing the customer new experiences—and he never stopped selling. He taught me a sense of urgency: you never stop selling. I just absorbed lessons from him. I watched every single thing he did very carefully.

PHILANTHROPY: He was always “telling a story”? What does that mean, and how important is it?

AMB. BRINKER: Utterly important. We do it at Komen for the Cure—every survivor’s story, every family member’s story, is what drives our organization and our mission.

Why is it so important? Well, a story gives meaning to whatever you do. I think of my collection of Hungarian art. It goes from 1866 to the present day, and it’s purposely broken down into periods of the Austro-Hungarian Empire, the interwar period, post–World War II. The art is beautiful, but it is especially meaningful to me because of the collection’s story.

You see, I started collecting when I was Ambassador. It allowed me to see the Hungarians’ country. I wanted to know about the country. I could not learn the language—it’s very difficult. The only way I could really understand the country was through the art. Then I began to love the art, because I started seeing it through the artist’s eyes, so I hope to be able to chronicle the contemporary part of it. I exhibited a lot of these pictures in the American embassy because I came right around 9/11, and there wasn’t a way to get American art into our embassy there—they weren’t sending things of value out of the country. So it became a great handshake with the Hungarians when I exhibited their contemporary art in our embassy.

But back to your point, stories are indeed absolutely central to communicating what we’re most passionate about.

PHILANTHROPY: You mentioned Stanley Marcus. Who else has influenced the way you think about marketing and business?

AMB. BRINKER: My father has been a huge influence in my life. He was a small businessman, and, before that, a traveling salesman. My father was a very hard worker—he worked his way up to developing shopping centers. He was very successful in Peoria, Illinois, where I grew up. He used to say, “Most people fail not because they have a bad idea, but because they quit.”

And then, of course, I was married to a genius in Norman Brinker, who was the father of casual dining restaurants. From Norman I learned team-building. He was a great listener. He was a great inspirational person, a great motivator. And to him, running his business was a little bit like putting together a football team. He wanted people to feel like they were on the team—not to feel that they were just employed but rather that they were part of the success of the business. I watched how Norman built concept after concept, tinkering with them so that they were really running before they were exported to another city or town—which is what we did with the Race for the Cure.

My only sister, Suzy, died in 1980. It was the biggest heartache of my life. Before she died, she told me, “Promise me it’ll be better for women with breast cancer. . . . Promise you’ll make it change.” Norman knew of my sadness about my sister’s death and the promise I had made, and he said, “Well, why don’t you start an organization?”

In those days, there was practically nothing like this for women diagnosed with breast cancer. It just wasn’t possible to talk about it. That was the challenge. How do you market or sell something that people can’t even talk about? If there is anything positive in this, how do you bring people to it so they can feel good? How do you bring them together and create hope?

PHILANTHROPY: You must have faced enormous obstacles.

AMB. BRINKER: Oh, certainly. Very little research was being directed from the National Cancer Institute to breast cancer research or to any targeted women’s diseases. It was thought that cancer is a disease that you study generally. Most people equated cancer with death, or at least with a lot of disfigurement, and many were more afraid of the treatment than the disease. Also, advocacy movements still scared people. They don’t quite know how to join. In our case, they didn’t want to go to any more sit-ins—they had already done that in college during the Vietnam War. People wanted to know if they could actually do something for a cause.

And that’s what I think we offered at Susan G. Komen. We offered a way for people to come together to communicate their feelings, to bring their stories to the table. This was a very personal reach to someone. “Come and share your story,” we said. “Come and talk to me. Tell us where you’re hurting and what you need to know. Let us help you find the resources.”

PHILANTHROPY: It sounds as if you were applying the lessons you learned from Stanley Marcus about “creating an experience.”

AMB. BRINKER: Yes, I think that’s right. I saw this very clearly after spending all the time I did at Neiman Marcus and watching how private-sector marketing works. We’ve got to deliver the message in ways that people can receive it. They weren’t getting it from TV, from magazines, from newspapers—they wouldn’t even print the word “breast”! That had never been done in a public setting before. Then, you went to a physician. The physician told you what to do, but you didn’t call a hotline, and you sure as heck didn’t go into town hall meetings and talk about your breast cancer. Breast cancer, like all cancers, was called the “Big C.”

In fact, there was very little private philanthropy going to breast cancer. Using private philanthropy to find a cure—how I envisioned Susan G. Komen—was an outgrowth of my experience as a child. Along with our mother, Suzy and I were very involved in the March of Dimes, the national campaign to eradicate polio. At the time, people were quarantined when they got polio. When we saw our little friends again, many were disfigured. Sometimes they would die. We watched the whole nation galvanize around fighting a disease: the private sector, the public sector, your teachers, your doctors, your postal workers. You could hardly walk out of the front door without a March of Dimes lady saying, “I need your dimes!” In 1955, the day that Jonas Salk’s vaccine was announced, the factories in Peoria shut down. The church bells were ringing. The principal got on the loudspeaker and we were all sent home. It was as if a war had ended. And it had. We had a vaccine.

PHILANTHROPY: But we’ve not achieved a polio-style victory over breast cancer.

AMB. BRINKER: No. I thought when we started this that we would have this done in 10 years. That’s how young, naïve, and silly I was. We had put a man on the moon, and President Nixon had launched the “war on cancer” in 1971. So by the time we had started Komen, I thought, piece of cake.

Our research program overall has been a real star. As of this year, we’ve funded almost $700 million in research.

Komen has touched many—if not most—of the scientific advances in breast cancer since we started in 1982. We’ve supported the understanding of genetic susceptibility to breast cancer, including the BRCA1 and BRCA2 gene mutations, the development of treatment and prevention therapies for hormone-dependent breast cancer, the identification of HER2-positive breast cancer and the development of HER2-targeted therapies. We’re supporting new work developing breast cancer vaccines, searching for biomarkers, and on and on and on. We’ve funded over 2,000 scientists since we started. We’re the largest private funder of breast cancer research in the world.

PHILANTHROPY: Which of these advances stands out to you?

AMB. BRINKER: Well, there’s BRCA1, the breast cancer susceptibility gene 1, carried by 1 in 200 women, who have a lifetime risk of 60 to 90 percent for developing breast cancer. For me, it was a bittersweet experience because I’m BRCA-positive. I’m sure my sister was, too. But it has been an amazing discovery. Not only have we funded a study of BRCA as a genetic base for describing who might be more at risk for breast cancer, it’s also going to serve as a basic understanding of how we develop treatments for one of the most aggressive kinds of breast cancer: triple-negative disease, which doesn’t respond to either hormonal treatments like tamoxifen or inhibitors like Herceptin.

Our research program overall has been a real star. This year, we’ve given away $66 million in funding for research. As of this year, we’ve funded almost $700 million in research. We like to make big investments in several areas now. For many years, we largely funded cancer biology. Now we are funding cancer biology and cancer treatment, prevention, early detection, and disparities in breast cancer outcomes.

Most of the research we fund is translational, meaning that it connects findings from basic, laboratory-based scientific research into medical advancements, medical practice. We’ve invested $2 million with Indiana University, funding the Susan G. Komen for the Cure IU Tissue Bank, where healthy breast tissue is being carefully digitized so any pathologist around the world can use it. We’ve funded $84 million in Promise Grants, which are large, multi-year grants that work across different disciplines and even across different institutions on big issues. Those are the kinds of things we do. We like to go and fund the people doing this research.

PHILANTHROPY: What about grants that, for whatever reason, don’t pan out as expected?

AMB. BRINKER: I don’t think there is anything we have invested in that was a complete flop, that left us feeling embarrassed. We have been pretty fleet of foot—if something isn’t working, we just move on. We just don’t feel we are an organization that should be funding things ad infinitum. And we really like to fund people who need that one, early boost.

PHILANTHROPY: Do you think that research funded by private philanthropy is more independent? Does it have more freedom of action than that funded by the government?

AMB. BRINKER: Sometimes it does, sure. Researchers often do not feel held up by us. They know they have a little more freedom, and they might be given an opportunity to let their study take an unexpected turn. Whereas if they are taking a government grant, an NCI grant, it would be a very different thing. Our grants allow for a more visionary quality, I think.

Plus, they’re now going to be in a very august group of people who are able to then shape the next chapter of what they’re doing. That’s very exciting for scientists. Nobody likes to do science in a vacuum. Scientists like to communicate and collaborate. Incidentally, that’s a problem for a lot of corporate research.

PHILANTHROPY: Doesn’t collaboration take place with for-profit researchers?

AMB. BRINKER: Not always. Sometimes the private sector is reluctant to share its findings—they don’t want to share data, for understandable reasons.

PHILANTHROPY: Apart from research, what else does Komen fund?

AMB. BRINKER: Research is one of the four pillars that hold up our Susan G. Komen house. The other three are community health, advocacy, and global reach. Last year, research accounted for about a quarter of our mission spending, or $75 million. We spent about half of our mission funds on education, and the rest on screening and treatment programs.

On the community health front, for example, in Montgomery County, Maryland, we helped shorten the length of a diagnostic procedure. Women were getting mammograms through a community program we do, but it was taking sometimes as long as 110 days for them to get follow-up. We shortened the follow-up period to less than a week.

I think a lot of people tend to think about us in terms of events like the Race for the Cure and icons like the pink ribbon. That’s because of our affiliate network—where we’re in the communities. Thanks to our affiliates across the country and around the world, we’re able to offer these kinds of community health programs. Whether they are working for the organization or one of our tens of thousands of volunteers, everybody is working for this mission. And when you see the results, when you see the power of what we can do—well, that’s the sexy part of working here.

PHILANTHROPY: How does having local affiliates fit into your overarching goals?

AMB. BRINKER: All health care is really local, and that’s key to this effort. Some people can go to regional cancer centers throughout the country, but by and large, most people receive their health care locally. I think our organization has thrived because we understand how to train people at the local level, to create awareness and successful programs, and then how to build programs to raise money to get people to volunteer, to keep them affiliated with the cause. And even though we are sometimes criticized after the month of October [National Breast Cancer Awareness Month] for saturating everything in pink, it’s very deliberate. Make no mistake, it is deliberate. Pink isn’t about selling products. It’s the power of millions of people who want to see women live long, normal, healthy lives.

PHILANTHROPY: That reminds me of something you wrote in your memoir, Promise Me. You said that your corporate partners’ core purpose is profit. If corporate philanthropy and brand-led marketing don’t help the companies’ bottom lines, should they do it?

AMB. BRINKER: Let me clarify a couple things first. There are several pockets that we get donations from. One is cause-related marketing, where the brands appear with our logo and we get a percentage donated from their purchase price, or a flat donation for a set period. Corporations are also giving larger grants from their corporate foundations, and that’s a different pot of money from cause-related marketing.

As for cause-related marketing, if a corporate partner is not doing well, we’re not going to do well. We insist on a really balanced relationship. We don’t go into one of these programs unless we make sure that the disclosure is correct, our symbols, our messages, and everything else are transparent and clear to the consumer; likewise, partners don’t want to go into a program unless they are going to have some visibility with us. I think that’s a pretty fair deal, and it returns almost $38 million annually to us in contributions.

PHILANTHROPY: What philanthropists inspire you in your work?

AMB. BRINKER: One of my favorite donors of all time is David Rubenstein [co-founder of the Carlyle Group, a private equity firm]. He has come to our large affiliate meeting with 1,100 participants. (People come and learn what we’re doing, and they take the information back to the affiliates.) David spoke to our grassroots leaders and fundraisers about philanthropy and how to raise money from people like himself. He is just phenomenal.

Then there are Margaret Hunt Hill and Ruth Altshuler, who were the first major donors to this organization in 1983. Ruth was one of my early mentors. At the time, there weren’t that many women mentors. I was lucky enough to find a few women like Ruth. She’s unique, inspirational, leads by giving, and gets other people to give. She and Margaret led with their gifts. They led with their knowledge. And they led with their hearts. We need a lot more people like that now, particularly people who want to make a real mark on the work going forward, like David has done.

PHILANTHROPY: How will you and your family continue to be involved in SGK?

AMB. BRINKER: Well, my son, Eric, is on the board. He grew up with this. He remembers at age five having his room filled with bottles of men’s cologne for the first Susan G. Komen fundraiser in 1983. It was a luncheon in Dallas where [former First Lady and breast cancer survivor] Betty Ford was coming to talk, and he remembers that visit because he had a headache for months with all of that stuff in the room. He grew up with more pink than any boy should ever have to! Today, of course, he understands the organization very well. I hope there will always be someone from the family—from Suzy’s family—on this board.

PHILANTHROPY: And how do you stay fired up?

AMB. BRINKER: There is still so much to learn and do. And I wake up every day shocked that I don’t know more than I do. There is always something going on that is troublesome, or difficult to handle, or that needs advancing, or that’s not going fast enough, or that’s going too fast. It’s not enough to plan. You have to have that sense of urgency. And the public now is expecting us to do it. We always feel like we’re racing. We really are racing for the cure.