The mission of the Avon Foundation Breast Cancer Crusade is to raise funds and awareness for advancing access to care and finding a cure for breast cancer, with a focus on the medically underserved. From its launch in 1992 through 2006, the multi-faceted initiatives of the Avon Breast Cancer Crusade have raised and awarded more than $450,000,000 to the breast cancer cause worldwide. Funding is awarded to five areas: breast cancer education and awareness, screening and diagnosis, access to treatment, support services and scientific research. Avon now supports programs for breast cancer in some 50 countries around the world.

Knowing that breast cancer is the most commonly diagnosed cancer among women, the goal of the Avon Foundation Breast Cancer Crusade is to benefit all women. However, there is special emphasis on reaching medically underserved women, including low-income, elderly and minority women, and women without adequate health insurance. Reversing historical disparities in breast cancer care is a priority of the Avon Foundation Breast Cancer Crusade.

What Makes the Avon Foundation Breast Cancer Crusade Unique

The Avon Foundation has implemented a comprehensive need-based philanthropic strategy that addresses every facet of the disease. Recognizing the complexity of the problem of breast cancer among all groups of women, Avon is distinguishing itself from others that fund a single institution or scientific investigator by supporting a virtual national network of research, medical, social service and community-based organizations, each of which is making a unique contribution to helping patients or advancing breast cancer research. In addition, the Avon Foundation facilitates collaboration among the various organizations, institutions and investigators and bridges breast cancer physicians at academic medical centers and public and community hospitals.

Addressing the Full Spectrum of Needs in the U.S.

• Breast Cancer Education and Screening for Medically Underserved Women Through the Avon Foundation Breast Care Fund (AFBCF), an arm of the Avon Foundation Breast Cancer Crusade, the Avon Crusade supports more than 125 community-based organizations each year across the U.S. that are particularly effective in reaching women who face barriers to obtaining health care. Grants from the Avon Foundation Breast Care Fund enable these organizations to conduct community outreach to identify women who need help; education on early detection; and assistance with the process of obtaining screening and needed follow up care. These programs target the uninsured, low-income, elderly and disabled women, minorities and those for whom English is not the primary language, and women who have competing survival priorities as a result of living in poverty. The AFBCF has secured screening exams and mammography for more than 550,000 women from 2000-2006 and educated more than 7,800,000 on breast cancer. Of the clients served, 64% have no insurance and more than 2/3 are from underserved populations.

• Understanding the enormous challenge of reversing historic health disparities for the underserved, the Avon Crusade goes far beyond simple “check writing” philanthropy. The Avon Breast Care Fund provides an expert Coordinating Center to provide technical assistance for the personnel at the community-based programs, and sponsors educational and training conferences. As a result, the program personnel learn effective education and case management techniques, data collection and program evaluation, and up-to-date breast cancer medical facts, as well as processes to obtain additional funding from other sources to sustain their programs. A website is also maintained for these programs so they can communicate with each other and the Coordinating Center. More than 1,000 grants to community-based non-profit breast health organizations in every state and the District of Columbia have been awarded since the Avon Crusade began in the U.S. in 1993, with more than 100 currently funded each year.

Gaps in Support to Complete Diagnostic and Treatment Regimens

• Despite the availability of low or no-cost mammograms, few resources exist for medically underserved women with a breast abnormality that requires further clinical care. To assist women facing this problem, the Avon Crusade funds a network of public and community hospitals to ensure timely follow-up to abnormal screening exams. Funds support patient navigators, breast program coordinators, outreach workers, and tracking systems to insure women are not lost in the “healthcare maze” that breast cancer patients often face.

• The Avon Crusade also funds a financial assistance and support service program with Cancer Care, Inc., called “The AVONCares Program for Medically Underserved Women”. This program provides funds directly to a woman or her health care provider for diagnostic care (e.g. biopsies), and provides funds to the woman for services such as transportation, child or elder care during treatment. Information on managing treatment, the provision of wigs and prosthesis, and psycho-social support is also provided by qualified social workers.

Scientific Research and Clinical Care

The Avon Crusade provides funding to cancer centers at leading academic institutions for their research programs, and requires the centers to establish or enhance efforts to care for uninsured and underserved breast cancer patients. In addition to the innovative care programs at individual Avon Foundation Breast Cancer Centers, the Avon Foundation expanded its care programs to encompass a national program supporting “safety net” institutions – public and county hospitals. In 2004 through 2006, Avon funded safety net programs at more than 40 institutions to support patient navigation, upgrade equipment or purchase key breast cancer treatment equipment that was lacking (such as sonography or digital mammography).

The research programs provide funding for a broad spectrum of breast cancer research at nearly a dozen direct leading academic medical centers nationwide as well as the National Cancer Institute, a part of the federal National Institutes of Health. Overall, in the U.S. the Avon Foundation gifts support approximately 400 investigators, physicians and scientists dedicated to breast cancer, and about half are women.

Recipients of Avon Foundation funding are encouraged to support a “team” or institution-wide approach among the faculty at every center and the Foundation facilitates cooperation among the centers. Funds are targeted to areas not adequately funded through federal funding mechanisms or other sources. In addition to gifts directly to cancer centers, an unprecedented public-private partnership called the Avon-NCI Progress for Patients program was created with a $20,000,000 gift in 2001. This funding currently supports 45 active clinical breast cancer research projects including: 2 chemoprevention, 2 diagnosis, 3 early detection, 3 prediction, 5 prevention, 3 prognosis, 1 risk, 17 novel treatment strategies, and 2 vaccine-based studies.

The funding priorities for research and care include:

• Identification of novel targets and agents for breast cancer prevention and therapy.

• New imaging and molecular methods to detect breast cancer early.

• Support for young investigators, to encourage them to explore new ideas and obtain critical pilot data.

• Salary support for physician-scientists (M.D., Ph.D.), who face challenges pursuing research with the demands of providing clinical care in the current environment.

• Career development for women physicians and scientists who are conducting breast cancer research.

• Support for stellar cancer researchers whose primary research in cancer pertains to other organ sites, to encourage them to spend a portion of their time and talent on breast cancer as well.

• Studies to examine the differences in breast cancer mortality between various groups of women, including African-American, Hispanic and Caucasian women. Studies will examine biological, behavioral, cultural, economic and health service system variables.

• Infrastructure, training and personnel to bring emerging new technologies, including functional genomics, to low-income women who would otherwise not receive the benefits of the progress in molecular biology.

• State-of-the-art care to medically underserved women in the geographic region of each medical center.

• All centers must work together on the challenges associated with reversing health disparities via conferences and meetings sponsored by the Avon Foundation.

To extend shared knowledge and collaboration, the Avon Foundation hosts a biannual Scientific Symposium for representatives of funded institutions and other leading organizations covering key areas of current research and care.

Professional Education: Special Needs

• Beginning in 2001, the Avon Foundation Breast Cancer Crusade needs-based approach has extended to training radiologists in the sub-specialty of breast imaging. A crisis is emerging as fewer radiologists enter this vital field due to factors such as low reimbursement rates and high rates for liability insurance, which have created a disincentive for physicians to become experts in breast imaging. Until these public policy challenges are resolved, it is important that fellowship support, such as the Avon Foundation Breast Cancer Crusade funding, be provided to continue training in the sub-specialty.

• The Avon philanthropy also includes fellowships and salary support for minority investigators to attract them to the field of breast cancer and obtain training at leading cancer centers.

Unique Fundraising Efforts Worldwide

The Avon Breast Cancer Crusade raises funds through many initiatives, including the year-round sale of special Crusade “pink ribbon” products by Avon independent Sales Representatives around the world; special events, walks and runs worldwide, including the US Avon Walk for Breast Cancer series and the global Walk Around the World; local fundraising programs; direct online donations.

Since 1993, Avon independent Sales Representatives in the U.S. – some 600,000 strong – have sold an array of Crusade “pink ribbon” products, including lipstick, pins, pens, mugs, candles and bears. All Crusade products are affordably priced to allow everyone to participate and each returns all net proceeds to the cause, which ranges from 50% to 87% of the purchase price. Each product comes with a free Breast Health Resource Guide, which provides important information on breast cancer, early detection guidelines, a list of medical and support resources, and a glossary of terms. The Guide is also available online in a printable format in English and Spanish at www.avonfoundation.org.

Worldwide Impact

The Avon Breast Cancer Crusade was launched in the UK in 1992. While the US Breast Cancer Crusade is the largest program, Avon now supports breast cancer programs in some 50 countries worldwide, raising funds and awareness while breaking cultural, social, financial and medical barriers in the breast cancer cause. Award-winning Avon breast cancer programs are saving lives in countries as diverse as Argentina, Australia, Brazil, China, Czech Republic, Italy, Malaysia, Mexico, Poland, the Philippines, Turkey, and many more, making Avon a leader in global women’s health.