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

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Abstract:

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.