“I am happy with one”: Re-evaluating the relationship between gender, breast-cancer surgery, and survival

Publication Type:

Journal Article


Agenda, Volume 27, p.55–64 (2013)




This Article challenges the perception that women with breast cancer experience mastectomy as devastating, because of the value they attach to having two breasts. This argument is based on ethnographic fieldwork conducted at the Helen Joseph Breast Care Centre, a public health facility in Johannesburg, South Africa. Findings from this research contradict existing local and global research that has generally represented breast cancer and mastectomy as a cosmetic crisis for which the remedy is reconstructive breast surgery. At the Helen Joseph Breast Care Centre women were not especially fearful of mastectomy. Many patients, however, resisted the reconstructive surgery available to them, saying that they were content to have only one breast. Women also defied the notion that having two breasts is essential for women to remain attractive and to maintain heterosexual relationships. Breast cancer patients in this context were significantly less preoccupied with reconstructing a prior gendered body than they were with ensuring a healthy body. This Article aligns itself with feminist critique that suggests that portraying breast cancer predominantly as an assault on gendered appearance, misrepresents women as preoccupied with conforming to a normative, ‘two-breasted’ femininity. Rather, in experiencing breast cancer, women have a profound confrontation with their own survival, an issue largely obscured in existing evaluations of the relationship between gender and breast cancer surgery. This Article offers qualitative insights into breast cancer in South Africa – a developing health crisis that has thus far been relatively under-researched.

Medical Humanities in Africa

WISER is working to establish the field of medical humanities in South Africa with other partners at Wits and in the region. Medical Humanities took root in the interdisciplinary spaces between social history of medicine, medical sociology, medical anthropology, literary studies, art and film studies, cultural studies, politics, philosophy, legal studies, public health, psychiatry, medical economics and medical ethics. Although initially concerned with contrasting and comparing approaches from the humanities and medical science to themes of health, suffering, therapy, pain and illness, it has grown in ambition to consider the foundational question of what it is to be fully human, inviting debate around vital epistemological problems. The interface of medicine and humanities also demands a broadly interdisciplinary discussion about what constitutes evidence, and this is critical in the formulation of all contemporary political arguments, including health policies. 

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