As Breast Cancer Awareness Month begins, the pink ribbon remains a powerful symbol of awareness, solidarity and hope. It is also an opportunity to recognize something remarkable: women diagnosed with breast cancer today are benefiting from decades of research, sacrifice and progress made by the women who came before them.

It is easy to forget how new some of our most important advances in breast cancer care really are. For most of the 20th century, the radical mastectomy was the standard surgical treatment for breast cancer. It was not until 1985 that results from a NCI-supported clinical trial showed that, for women with early-stage breast cancer, removing the tumor and treating the breast with radiation could provide survival outcomes similar to mastectomy.

Science continued to move quickly. Researchers identified and cloned BRCA1 and BRCA2 in the mid-1990s, giving us a clearer understanding of inherited breast cancer risk. In 1998, a landmark prevention trial showed that tamoxifen could reduce the incidence of breast cancer among women at increased risk.

In other words, much of what we now consider modern breast cancer care is not generations old. Many of these breakthroughs happened within the lifetime of women who are still with us today.

Think about a woman diagnosed with breast cancer 30 years ago. She entered a medical landscape that looked dramatically different from the one facing many patients today. How cancer is diagnosed and treated was evolving in real time.

And that evolution was not simply the product of laboratories and institutions. It was built with the participation of patients.

Women who entered clinical trials helped researchers answer questions that had never been answered before. Women who underwent treatments when the long-term outcomes were not yet fully understood contributed knowledge that would eventually shape care for the next generation. Survivors and families shared their experiences, pushed researchers and health systems to listen and helped make quality of life part of the conversation.

Today’s women with breast cancer and their families are beneficiaries of that collective investment.

The result is a breast cancer landscape that can look almost unrecognizable compared with 30 years ago. We have more sophisticated screening, more precise ways to characterize tumors, more targeted therapies and a growing understanding that surviving cancer is not the end of the story. Quality of life, happiness, family planning, aging and long-term health and survivorship matter, too.

We should pause to recognize just how extraordinary that progress is.

But forward progress includes responsibility: we need to ask who is benefiting from what innovation and who is still being left behind. Because innovation does not automatically create health equity.

A breakthrough in screening does little for a woman who cannot get an appointment. A promising treatment cannot improve an outcome if a patient cannot afford it, reach it or take time away from work to receive it. And a clinical trial cannot tell us whether an intervention works equitably across populations if the people most affected by the disease are not adequately represented in the research.

This is especially important when we consider racial and ethnic disparities in breast cancer. Women can face multiple, overlapping barriers to breast cancer care. Women of color, women in rural communities, women with limited financial resources or insurance coverage, women with disabilities and women facing language or transportation barriers may encounter challenges at every stage—from screening and diagnosis to treatment and survivorship. Research suggests that the reasons are complex , shaped by geography, income, insurance coverage, health care infrastructure, trust and other social and structural factors.

We cannot solve those challenges simply by telling women to be more resilient. We need to build resilience into the systems around them.

That means the following:

  • Continuing to bring more women into clinical research and ensuring that studies reflect the diversity of the people who will ultimately use the treatments.
  • Designing screening and prevention programs around the realities of people’s lives, not simply assuming that everyone can navigate the health care system in the same way.
  • Partnering with communities—not simply bringing information to them, but listening to what they say they need.

This is where industry has a role.

Breast cancer is not only a health issue. It is also a workplace issue, a family issue and an economic issue. A diagnosis can affect a person’s ability to work, care for children or aging parents, maintain financial stability and participate fully in everyday life. Employers can help by making preventive care easier to access, providing flexibility for appointments and treatment and recognizing that survivorship does not necessarily end when active treatment does.

Health systems, researchers and community organizations have roles to play as well. We need stronger partnerships that connect scientific discovery with the people and communities who stand to benefit from it.

We can honor that progress by doing what they did: pushing the next generation of questions forward. The next breakthroughs may come from a laboratory. They may come from a clinical trial. But some of the most important progress may also come from something less technological: giving communities a stronger voice in determining what research is done, who participates in it and how health care is delivered.

We have come a long way in building resilience against breast cancer. Now we need to build the systems, partnerships and community power that make that resilience that is sustainable and available to everyone.