In A World

In a world where too many women get breast cancer…

In a world where women are forced to make hard decisions….

In a world where we choose between knowledge and….

In a world that is obsessed with boobs….

Ah, I might be on to something with that one.

When my students write papers that begin with “In a world” or some other sort of vague movie-trailer nonsense, I get to slashing with my red pen (I don’t really do that, as it is against my pedagogical philosophy, but it sounds better than explaining said philosophy).  Anyway, it’s how I’ve been tempted to start this piece.  Lately, there have been articles all over the place citing this study and that study – the articles and studies all conclude that mastectomies don’t in fact prove to be any more effective as breast cancer treatment or as a preventative measure than their less drastic counterparts (like lumpectomies, surveillance, etc).  These publications explain that too many women are having unnecessary mastectomies, and they’ve gotten me to thinking, what kind of world do we live in where we question this sort of thing?

Let me explain my frustration.  I get annoyed when doctors (through journalists) start to analyze the reasons why women might choose to have mastectomies rather than pursue other options (for previvors options include surveillance and/or possible chemo-prevention drugs like Tamoxifen; for breast cancer patients, options might include less invasive surgery like a lumpectomy along with radiation and/or chemo).  This recent article, in the Wall Street Journal, like many, is a good example.  In it, one doctor chalks it up to anxiety:

I tell women, recognize that you are really treating your anxiety—and we have better ways to manage that.

Could this statement be any more undermining to women who make the decision to have a mastectomy from a place of power, not from a place of anxiety?  And even if a woman makes the decision to have a mastectomy out of anxiety, how dare you Dr. Partridge judge that fear until you’ve been in her shoes and heard someone say to you, “You have breast cancer.  Now let me go get you a Xanax.”

Excuse me while I go dunk my head in the sink in order to put out the flames shooting from my ears.

Another doctor in the same article, says:

I think that many women are simply terrified of the prospect of having to repeat the diagnosis and treatment experience.

Because surely, terror is simple (ask anyone who works for the NSA, and I’m sure they’ll tell you so).  More importantly, this sort of statement is completely demeaning to any woman who has had a breast cancer diagnosis and treatment experience – it diminishes everything she has gone through to something “simple” that she shouldn’t be afraid of experience again.

Please wait – bringing the fire extinguisher closer to my sitting area now seems like a better idea than continually dousing my head in water.

The reason I get so angry about these types of articles, and this one I cite from the WSJ is just one of many, is for two reasons.  First, although this article quotes a surgeon who says, “Patient choice is taking a much larger role,” that statement is glossed over as if choice couldn’t possibly be a good enough reason.  There has to be something more – fear, anxiety, terror – basically, just women being hysterical, right?  (and I mean that in the etymological sense of the word).  We can’t just accept that women might be making a rational choice to do this.

This leads into the second reason,  which has more to do a bit to do with the world we live in now.  And this goes back to the top of this blog entry.  We live in a world that is obsessed with boobs.  But is it possible, just a little bit possible, that with the pervasiveness of breast cancer – it is everywhere we turn, everyone we know knows someone who has it – that maybe some of us are starting to think about breasts a little bit differently?  Maybe some of us are starting to realize that breasts have the potential to be dangerous. And maybe we don’t care if we have them anymore, and we aren’t so impressed by everyone else’s?.

I’m not saying that breasts don’t matter to women, or men for that matter, nor am I saying that women shouldn’t love their breasts or be sad about losing them.  It is a hard decision to remove a body part, whether you know it’s definitely cancerous or in the case of a previvor, you expect it to one day become so.  I’m just wondering if our perception of breasts as an essential part of our identity is becoming a little diminished as we begin to recognize just how many women are so easily harmed by these things.

So, maybe the decision to have a mastectomy isn’t about fear or terror or anxiety, and it’s more an intellectual decision.   That’s not to say that it’s made without emotion.  But it’s frustrating to read these doctors and journalists who imply that women are making the wrong decision in choosing mastectomy because they can’t get their emotions out of the way.  Especially because I’m pretty sure that we live in a world where a lot of women do things with their brains.



  1. One can live without breasts — can’t live without a brain, liver, kidneys, lungs, bone. . . pretty simple. The cultural and social attachment to breasts and what they mean sexually is overdetermined and borders on obsessive. I am so tired of male physicians telling women they are hysterics (didn’t we retire that diagnosis a century ago?) and overreacting. It is so hypocritical to be perfectly fine with breast augmentation under virtually any circumstances and at the same time interrogate and scrutinize BRCA+ and other high risk women’s choice to have prophylactic mastectomy. Of COURSE ppl are terrified to repeat diagnosis and treatment — surgery, chemotherapy, radiation, and hormone therapies are NOT BENIGN INCONVENIENCES they are themselves irreversibly damaging and often even life-threatening. What a jackass comment.

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