Blinded by Rose Colored Glasses: Let's fight Pinkwashing

Corporate pinkwashing in action

We've all seen them-- the pink ribbons splashed across jackets and water bottles, spatulas and rice cookers. It seems so innocent at first-- most of us have known someone in our lives who has gone through breast cancer. For me, it was my mom. My aunt's best friend who I saw this past Thanksgiving just got diagnosed and is going through her first round of chemo.

Supporting these women is important. For people who have survived other cancers, the pink propaganda splattered across every household item rubs them the wrong way. "Thinking pink" is no only non-inclusive inherently (as campaigns and research routinely prefers white women over others who suffer from breast cancer).

Pink dominates the cancer awareness scene-- but what a lot of people don't consider is who the pink ribbon is actually helping.

Hint: Its not the 1 in 8 women who will be diagnosed with breast cancer (in the U.S. alone).

Of course breast cancer awareness is integral. But as the rates of breast cancer in women keep going up, and we keep spreading "awareness", we have to stop and look at this movement critically. Aren't we past the point where we need to raise more awareness?

Personally, I've known about breast cancer since I was a kid. I've been told I'll need to start getting mammograms early, and to check for lumps regularly. Most women are very aware of the risk, and what to *try* to look out for. Unfortunately, breasts are so diverse that often women have trouble identifying what is abnormal or not.

Awareness is in the past

Political cartoon on the concept of pinkwashing

So why are we so focused on this concept of "awareness" where buildings are lit up in pink in its name and pink ribbons are embroidered on ties?

Corporate exploitation.

Pinkwashing is a term first coined by Breast Cancer Action. It refers to when a company or organization claims to care about breast cancer by promoting a pink ribbon product, but at the same time produces, manufactures and/or sells products that are linked to the disease. This can be anything from food items with pink labels to fracking companies that use pink screws for their rigs. Its corporate dishonesty and moral deficiency-- and so many people fall victim to it in the name of trying to do some good.

This is exactly why Breast Cancer Action launched their campaign Think Before You Pink-- to try to combat this corporate exploitation.

But is it enough?

When looked at through a critical ecofeminist lens, the plight is obvious. Women are targets and immediate victims of corporate greed-- just like the environment. This deeply connected to what ecofeminism discourse argues-- the corrupt hands of corporate America reaching its grubby hands deep into breast cancer awareness campaigns. Women are the most affected-- all this money that people think is going to women and fighting this epidemic the disproportionately affects women, and all of it is going into the pockets of big business-- more so than any other ribboned cause.

We're just a profit-booster to them.

One of the worst parts is that the people who most often fall victim to this kind of marketing and exploitation are those who have been affected by this cancer epidemic-- survivors, families, et cetera.At Thanksgiving, I overheard a relative explain how they always try to purchase items with the pink ribbon label-- in support of people like my mom.

To take advantage of people's hearts like this should be a crime.

Unfortunately, in corporate America where we love capitalism, its the exact opposite: a good marketing tactic.

Shattering of rose-colored glasses

So many people don't know the facts behind the pink ribbon and all the media that comes with it. And don't get me wrong, there is absolutely nothing wrong with showing solidarity and bonding with others to share experiences. But we need to fight against corporate pinkwashing.

So, how do we stop this, or at least make it better?

First, lets shatter the rose colored glasses.

Educate yourself. Before you buy anything with the pink ribbon, research the company. See if any money actually goes to a research organization (Susan G. Komen doesn't count).

Include everyone affected by breast cancer intersectionally-- everyone's voice matters, and everyones experience matters. No two are alike, and breast cancer affects so many people.

Support your loved ones in other ways. We need to stop thinking pink and start thinking human.

Women Without Breasts Are Still Women

Women Without Breasts Are Still Women

The focus of a breast cancer survivor should be the woman, not her anatomy

The New York Times

We must stop imposing our patriarchal views of what a woman is supposed to look like on breast cancer patients. 

It is engrained in us to attach a certain value to women's breasts in respect to their femininity and value. But the decision to undergo reconstructive surgery or wear breast forms should be left up to a woman - and her alone. 

Following her double mastectomy at age 34, Cathie chose not to use any type of breast forms. A fitness instructor, Cathie found her prosthesis to be too "uncomfortable" and"impossible to wear" while teaching her classes. Her decision was a difficult one, but one that she felt was necessary for her own body. 

Cathie

"Going flat", as many women and physicians call it, is the decision that women who have had a mastectomy make to not have any further reconstructive surgery or prostheses. However, the majority of women still continue on with the reconstructive process. It is a deeply personal choice and it is one that should not be imposed upon by others.

Chiara D'Agostino speaks of her own decision to go flat, which was influenced by an article in The New York Times that featured "strong, beautiful, and creative images." This representation of women without their breasts depicted in a beautiful, strong manner is important in framing the narrative of empowered, breast-less women. It allows for other breast cancer survivors to  see a physical example of these women and understand that their beauty is not intertwined to what is deemed as a "normal" woman's body. 

For some women, like Cathie, going flat was the right decision due to their love of physical activity. Some women prefer to not have any additional or unnecessary procedures. Some women want to get back to their everyday lives as quickly as possible. Some women just wanted time to heal. Some women with breast cancer do not have the choice of reconstructive surgery due to radiotherapy. And for some women, not having breasts is a part of their narrative in overcoming breast cancer. Reconstructive surgery is not the right choice for every woman, but it is their choice and their choice alone.

After having a mastectomy, women are bombarded with expectations about how they will once again return to their "true form". To be a woman in a patriarchal society, of course, means having breasts. Therefore, it is only natural that a woman who has had her breasts removed would want to have them back once again.

By pushing our expectations on breast cancer survivors to wear a prosthesis invalidates the struggle in which they experienced. This struggle is something of which to be proud. In fact, around 42% of women do not have any form of breast reconstruction post mastectomy. 

Audre Lorde

In The Cancer Journals by Audre Lorde, she states that “each of us [breast cancer patients] struggles daily with the pressures of conformity and the loneliness of difference from which those choices seem to offer escape. I only know that those choices do not work for me, nor for other women who, not without fear, have survived cancer by scrutinizing its meaning within our lives, and by attempting to integrate this crisis into useful strengths for change.” Herein lies great power for these women in the choice of whether or not to seek restoration of their breasts. 

Furthermore, Lorde recalls an instance where she was told by a doctor that she should wear her prosthetic breast in order to "boost the morale" of her fellow breast cancer patients. Boosting the morale of these breast cancer patients is synonymous here only with having one's breasts back. Breasts, in the realm of breast cancer survivors, are equated with strength, warriors, and success. Implying that breast cancer patients need them in order to claim victory over the disease or regain a sense of self-worth is an unfair sentiment that undermines all women. It puts their validation in the hands of others instead of themselves. It does not allow for women to reclaim their own bodies from cancer. Lorde was enough with and without her breasts - a prosthesis or surgery never had the capability to change that.

The New York Times

There is nothing wrong with choosing to have reconstructive breast surgery or choosing to wear prosthetics. Choosing this route is empowering for many women. It makes them feel more attractive. It makes them feel like their old selves. For the majority of women, reconstructive surgery or the use of breast forms is the right decision for them. 

Choosing not to have breasts after having a mastectomy, however, is also empowering. These women are still themselves. And they are still attractive. Women can be all of these things - with and without breasts. The anatomy of a woman does not change her value. By implying that women should have reconstructive surgery or use some form of prosthetics is to say her value is directly tied to her physical body. 

This sentiment is untrue and must stop being perpetuated. What makes up a woman who has survived breast cancer is courage, strength, and perseverance. We can't continue to diminish these qualities with the sentiment that the power of survivors lies within their breasts. These qualities carry more weight in a person than does breast tissue. 

Going flat is a physical symbol of the strength these women contain. It is something to be proud of. It should not be seen as something abnormal or something that is needed to be fixed. But, most importantly, it is a decision to be made by the patient and only her. Women deserve to make this decision without the pressure of outside forces. 

Cathie goes on to state that "breast cancer never truly leaves you," but isn't that the point? We often long so much to return to normalcy after a difficult life experience, whether it be cancer or the loss of a loved one, that we don't quite accept that these hardships make us who we are. They do not define us, but rather they shape us into the people we are today, they contribute to our character, they make us grow.

The breasts of women who have survived breast cancer are not symbols of her success. They are not comparable to her tenacity. The woman herself is - we must remember that.

Pink is not the answer

Cancer has become a billion dollar industry that not only empties pockets but also households. Foundations like Susan G. Komen who facilitate global marketing and consumerism scams to entice buyers in benefitting their cancer curing brand, when in fact brands like Komen profit off cancer as a whole. Susan G. Komen has raised about 956 million dollars since its founding. The allocating of these funds have created a distrust among the array of breast cancer foundations since the “non-profit” organizations CEOs are making more than doctors, politicians, and lawyers. Why should working people be donating to a “non-profit” whose CEO makes more than 684,000 dollars a year? Clearly, not all of the donations and sponsorships are going directly to breast cancer patients nor to finding the cure. From 2009 - 2010 only 20.9% of the funds generated by the pink ribbon foundation were used. Where are the millions of dollars going? 

The ugly truth that lies beneath Breast Cancer and many cancer foundations illustrate a capitalistic approach to endorsing a preventable systematic killing of women (and men). If the cancer industry is continuously showing its profitability in marketing and consumerism, than the capitalistic society we live in thrives off the sickness cancer distributes among women. With this system generating billions of dollars, why would industries like Susan G. Komen fight to find a cure that could potentially end majority of the fiscal contributions their foundation generates? Without this cancer circle the CEO’s and directors of Komen would not be making millions of dollars. This incentives cancer curing agents to avoid curing techniques due to fear of lack of profit. 

The largest portions of Susan G. Komen’s funds is allocated to public health education, which essentially brings awareness to screenings and public awareness of the disease itself. This in itself is a beneficial factor but it’s imperative to realize that this process also profits Komen. This advertising is bringing Susan G. Komen’s foundation millions in return while establishing public support for their own “life saving” foundation. Creating a systematic money pool that aids themselves and creates a decent public service sector via advertising. But what’s puzzling is Komen’s main point of its foundation is finding a cure, yet more than half of their proceeds go towards awareness of screenings and not towards finding a cure.  Maybe because if a cure was ever found Komen would lose majority of its proceeds? Becoming aware of cancer and treating it does not equal a cure which is oddly Komen’s mission statement. If a foundation like Susan G. Komen authentically wanted a cure more of its proceeds would be going directly to funding for a cure or directly aiding women who cannot afford their treatments. 

Susan G. Komen receives over 55 million dollars a year from America’s prized, genetically modified, toxin loving companies like KFC, Coca-Cola, and General Mills who all have warnings of possible cancer causing agents in their ingredient disclaimers. Nothing says cancer prevention like eating a bucket of cancer ridden chicken! It’s also important to note that none of these brands appear on the Susan G. Komen for the Cure website. All of the sponsors are of healthy and active perspectives like Get Air, Zumba, WWE and more. Komen is hiding its partnerships with cancer filled companies to continue to pretend that their foundation is combating cancer and unhealthy lifestyles when in reality it’s supporting the purchasing of junk food that can directly cause cancer. 

Also, having pink ribbon products further incentivizes people to consume products. Trent Stamp, executive director of Charity Navigator describes that it’s often rarely more than a penny on the dollar that's contributed to the cause, it’s simply just great advertising. Both Komen and the companies that are promoting and creating these pink products are aware of the national perception that is created when supporting breast cancer. Consumers are more likely and willing to support and purchase products if it’s tied to a good cause. It’s also found that companies will create products with higher prices and a donation deadline yet will continue to sell even after that donation deadline to profit further. On top of the donating deadline, manufacturers and companies will put a donation cap on proceeds that are made, so if you buy your pink ribbon products after the cap is reached your money is just contributing to capitalism rather than a cause. Society is slowly recognizing these gimmicks and reacting in ways that raise awareness of the deceitfulness around cancer and the pink ribbon. Organizations like the Breast Cancer Action and Think Before You Pink campaign are spreading word of the issue with pink ribbon products, exposing them as cancer causing, environmentally harmful, and unhealthy options. These organizations are doing great work to expose the scam of Komen and establishing a fundamental resource for those affected by breast cancer. 

While Susan G. Komen is a corrupt foundation that exploits its audience it overall does create a safe haven of support for women who are directly affected by breast cancer. If you have ever been to a Susan G. Komen Walk for the Cure then you can understand the amount of energy, love and support that is admitted when people of all backgrounds, race, and sexualities come together to uplift everyone who has been affected by breast cancer. Breast Cancer is an authentic disease, taking millions of lives and leaving devastating holes in communities and homes. This disease needs to be combatted, those affected need a safe place to feel uplifted and hopeful and if SGK can give that to families or individuals in need then let it. But, to understand and admit  the underlying truth that Komen  is detrimental. As long as cancer is a for-profit, billion dollar industry there will never be a cure. Komen has no interest in finding a cure and would rather make millions off the fear and hope people have in finding it. If Komen really, truly cared about women affected by breast cancer they would put their energy and money to both finding a cure and helping patients who may not have medical insurance, or unable to cover any medical bills. This approach doesn’t generate millions of dollars so I guess they will just stick to endorsing cancer producing agents instead. 

Pink is not the answer. 

                                                Works Cited

Benfit, Emily, et al. “I Will Not Be Pinkwashed: Why I Do Not Support Susan G. Komen for the Cure.” Butter Believer, 14 July 2016, butterbeliever.com/i-will-not-be-pinkwashed-why-i-do-not-support-susan-g-komen-for-the-cure/.

But most importantly, how does she look?

When Angelina Jolie, a famous beauty icon in the modern media, made the choice to get a double mastectomy people in the public had a lot to say about her choices. A lot of the commentary about what she went through was inappropriate and insensitive to the seriousness of the situation.  

Jon Kopaloff/Film Magic

 The Daily Beast, a mostly gossip and news article cite,  posted an entire article about Angelina Jolie's double mastectomy. The article starts off by saying that, “There’s nothing sexy about a double mastectomy”. This article is instantly reducing the seriousness of a double mastectomy by sexualizing it. Not being “sexy” is far from the most important issue when one is dealing with a potential life threatening illness like cancer. The articles main purpose is to figure out whether or not Jolie's breasts will look normal again. They are only interested in the cosmetic aspect of the whole operation. They care little for her actual well-being and health.

            Media outlets such as this think it is okay to sexualize these cancer survivors because that is what people care about the most. People are more focused on beauty and appearance post cancer than they are with genuine emotional hardships and struggles with mortality that come with cancer. Focusing on appearance is a Band-Aid solution to a much deeper and sensitive topic that people do not want to have.

            Look Good Feel Better is a campaign that is built on helping cancer patients combat the appearance related side effects of cancer treatments. This program goes about helping individuals through makeup tutorials and demonstrations. The quick and easy fix to cancer is to put makeup on and feel better. Because if you look good, clearly nothing can be going below the surface.

This program is clearly not concerned with getting to the real conversations that could help. Not focused on why women are struggling so much or why cancer is so difficult to deal with. It is focused on fixing the surface level problems and making people seem happier and better. They could be encouraging conversations and discussions about how to feel good and confident despite maybe no longer fitting the “traditional beauty” standards. Instead, they push for conforming and ignoring what is really going on.

The Cancer Journals 

Audre Lorde, the black, feminist, lesbian, writes about her post mastectomy experience and how she felt the pressure from outside forces to cover up and move on. In her narrative about her experience, The Cancer Journals, Lorde writes that when leaving the hospital, the nurses strongly recommended that she wear the prosthesis given to her. Lorde did not feel comfortable or happy wearing the prosthesis but she did it anyways, because she did not feel like fighting it. Lorde realized that the prosthesis was pushed on her not necessarily for her own sake, but for others.

The nurse insisting that Lorde wear the prosthesis to keep up the appearance and moral of a breast cancer survivor is similar to what. Look Good, Feel Better is trying to do. The prosthesis just makes Lorde look “normal” to an outsider perspective, so no one has to know what she went through. But she will always know the difference and have to cope with it. Similarly, the Look Good, Feel Better campaign is about making women look and appear normal and healthy. Despite what they may have gone through all that matters is that they look normal to others.

It can be understood and respected that in fact some women do appreciate and enjoy campaigns such as the Look Good, Feel Better. For them, they may find comfort and solace in the connecting with their physical appearance post cancer. And there is nothing wrong with that. If it makes them feel good and better than that is great. However, the problem lies with when it becomes not about what the patient wants, but what other people want to see. People care what Angelina Jolie’s breasts are going to look like post mastectomy, not because they care that her decision makes her happy, but because it they want to still find her sexually attractive. If Jolie, a popular sex symbol, had decided not to go about implant reconstruction, people would have had things to say about it.

This all ties back to the obsession of the sexualization of women. Jolie is not the first or only women to experience being overly sexualized and be scrutinized post mastectomy. Women are constantly being forced to conform to beauty standards, even when they are dealing with life or death situations. They are encouraged to slap some makeup on and no one will know that they are suffering. No one will have to no what kind of pain they went through. All that matters is that they can still be traditionally attractive in the eyes of our society.

Sources

Lorde, Audre. The Cancer Journals. San Francisco, Aunt Lute Books, 1980. 

Breast Cancer Business

Breast cancer awareness has been a topic of interest that has attracted several companies and institutions to join the pink ribbon merchandise. The goal of the awareness campaign is aimed at educating women on the risks of breast cancer and the importance of early screening. Breast cancer awareness campaigns raise an average of 6 million USD annually, yet breast cancer still remains to be a top killer for women living in the United States with one in eight women developing breast cancer during her lifetime (Rosa, 2014). The reality is a hard pill to swallow: we are no closer to finding a cure for breast cancer than we were over two decades ago; in 1991, roughly 110 women died every day from breast cancer. That figure only dropped down to 110 women by 2011 (Goldman, 2011). 

Why is there such a discrepancy between breast cancer awareness and actually finding a cure? 

The bottom line is that breast cancer is a business that allows for people to get very wealthy (or accidentally allow for the misuse of money). This is widely due to the fact that breast cancer screening is seen as a personal responsibility. We don’t need more awareness, but we do need to be smarter about where we donate. 

There are several missteps that naturally occur in awareness campaigns. The first is that awareness focuses on personal responsibility. Instead of focusing on physician’s role in detection, breast cancer awareness targets the general public and places the responsibility of early detection of breast cancer on the individual; therefore, if you have advanced stages of breast cancer, which is often the case for ethnic minority groups, it was individual’s fault for not checking sooner. Of course, those living with a late stage of breast cancer are completely ostracized from this awareness campaign due to the focus on ‘early detection.’ The National Breast Cancer Foundation is saturated with hope, survival stories, and warrior narratives which, of course, is excited and sometimes necessary, but sadly only focuses on a single (survival) story. 

In addition, the breast cancer awareness campaign only goes as far to stress the importance of screening to the individual without considering the barriers to accessing screening. It is safe to assume that most people know someone who has experienced breast cancer (due to the high prevalence of breast cancer in the United States) and do not need to become “more aware” that at some point, they will need to get checked for cancer. 

But how does one actually go about getting a mammogram? Where is the best place to get one? How much does it cost? If it is passed down genetically, do I need to get checked sooner? This non-exhaustive list of questions has generally not been answered by the production of pink ribbons on shirts and pink water bottles from Dick’s Sporting Goods. If screening results, which can be expensive depending on insurance coverage, detect cancerous tissue, management, surgery, reconstruction, and/or medication can be incredibly expensive. 

But wait, doesn’t the money go to breast cancer research and the care of local women who have breast cancer?

Yes and no. Lea Goldman published an article in Marie Claire arguing why breast cancer was such a large business in the United States. A large part of the problem, now that companies have invested in the pink ribbon breast cancer awareness campaign, is that breast cancer awareness as a product makes people very wealthy. The Plainview Chapter of the Coalition Against Breast Cancer (CABC), for example, was supposed to be a foundation that helped local breast cancer patients pay off their medical expenses. The group raised over 1 million USD and yet, after viewing the public tax returns, investigators found that the CABC had donated absolutely nothing. 

Some charities are not so intentional in their lack of donations. Because many local and well-meaning breast cancer awareness campaigns are started by just a few, inexperienced people (often family and friends), donor dollars go towards printing brochures or awareness events rather than their designated research facilities. The American Breast Cancer Foundation in 1998 was founded by Phyllis Wolf and her son, Joseph. The two saw the discrepancy between awareness and more hands-on action and decided to financially assist breast cancer patients who did not have insurance. Though a noble goal, Joseph ended up setting out on his own in the telemarketing world (still aimed at breast cancer awareness) and pocketed 40 cents to every dollar he made in donations. He retired early after making around 18 billion USD (Goldman, 2011). 

Marie Claire: Pink Purchases

Simply because a brochure, piece of clothing, or packaging has a pink ribbon “doesn’t always mean that a good breast cancer charity is benefiting from your purchase,” Better Business Bureau executive Michelle Corey noted. According to Goldman, one of the first searches on google for pink ribbon is a site owned by Walter Scheffrahn who, at the time of publication, had not yet donated the 20,000 USD his cite had attracted from people nor had he figured out to which organization it should be given. 

With so many companies and organizations across the world supposedly bringing in money to support breast cancer awareness of persons with breast cancer, the effort becomes diffused. The president of the National Breast Cancer Coalition, Fran Visco described the effort as, “putting them (money) into little pots all across the country…taking away from the efforts that can and do make a difference.” Instead, Visco says they should be focused in putting themselves out of business. But, as Goldman comments, why close up shop when business is booming? 

If you are considering donating to breast cancer research, I strongly encourage you to dig deep into the company/organization/product before putting money down. Check out Goldman’s article here to find a list of credible foundations aimed at funding research and treatment. If you have questions about mammograms, check out the CDCs website, which provides helpful links and definitions as well as answers to common questions. 

Let's Focus on the Woman, Not the Easy Solution

John Hopkins Medicine

Personally, I find it insane that we have yet to find a better solution to breast cancer than mastectomy. Why do we need to rely on completely tearing away a part of a woman's body in order to solve the issue of their breast cancer? Certainly there must be a way that is much better for the woman psychologically and emotionally.

We have placed too much faith in the solution of a mastectomy as being a quick way to get rid of breast cancer without recognizing the hurt and pain women go through when they have to deal with this procedure. These women have lived with and learned to love their breasts and to be faced with the idea that they have turned traitor against their own body by having breast cancer is very painful. Since this appears to be the one solution for women who go through breast cancer, they either risk death or have to lose a body part. If we put more research and time into finding additional solutions to breast cancer we might find a solution that is much more preferrable among women. Having additional choices in how to handle their breast cancer may make these women's lives a little more positive.

About 1 in 8 US women will develop breast cancer over the course of her lifetime. In 2018, an estimated 266,120 new cases of breast cancer will be diagnosed in women in the US. Early diagnosal has not made too much of a difference as the estimated amount of women to die from breast cancer in 2018 is 40,920 compared to the 40,290 in 2015. Granted, this wasn't a huge increase in expected deaths from breast cancer, but we should be working on decreasing deaths rather than letting them remain stagnant and continuing.

SRG Tech

A big part of organizations who raise awareness for breast cancer is the push for early detection leading to early diagnosal. The idea behind this is that if women are regularly going in for check ups, screenings, and doing their own self-examinations, that is the best defense against breast cancer. Where this hurts women is that it puts the responsibility and pressure the women to recognize when they have breast cancer and deal with it accordingly. The issue resulting from this responsibilty is that women may not always have the means or resources to get help or know when they have signs of breast cancer. Getting regular check ups and screenings can't always happen if a woman does not have access to health insurance. Recognizing what the signs of breast cancer look like may not be possible either if women do not have access to information on what breast cancer looks like. 

Along with pushing responsibility onto women, early detection lets doctors rely on methods to deal with breast cancer after it has developed rather than coming up with additional methods that would work to prevent breast cancer from ever developing. This then pushes women to accept one method in order to save their lives through a mastectomy. One such individual who was initially only given the option of a mastectomy was Desiree Basila. Desiree had been diagnosed with stage 0 breast cancer. The first surgeon she met showed her a photograph of her right breast and told her there was a slot open the following week for a mastectomy. Desiree
knew she was not ready to have one or both of her breasts cut off, so after talking to another doctor she decided to take a drug called tamoxifen which blocks estrogen and was in a clinical trial with active surveillance. As long as the tumor did not continue to advance, Desiree would not have to go through a mastectomy.

Granted, Desiree's story and her diagnosis was only stage 0 and not one of the more severe forms, if she was able to avoid mastectomy why can't we put more research into breast cancer and find other solutions that do not involve the complete removal of the breasts or to the point where a woman does not have to face death.

I understand that a lot of research and time has been put into breast cancer and I acknowledge that my knowledge of breast cancer and is very limited. I am not fully aware of the all the efforts that have taken place to find a better treatment for women, if there are any.

I hope we can think more broadly about how to treat this cancer rather than just removing the site where it develops - the breasts.

Reading:
Lorde, A. (2006). The cancer journals. Aunt Lute Books.

Breast cancer treatment is about saving lives, not breasts

The goal of treating breast cancer is to save someone’s life, not someone’s breast. 

This seems an obvious statement and yet, there is a strong narrative which values the appearance of a woman’s breast as the manifestation of her femininity and sexuality, of her identity.

It is clear that breasts are a site with much imbued meaning, whether individual women want their breasts to be viewed this way or not. A woman’s breast is seen both as a sacred and maternal body part which provides sustenance for children and also as a highly sexualized part of the body. Often, regardless of the viewpoint of a woman, partners, children, family members, and society as a whole place significant meaning on her breasts. 

Audre Lorde

 In her book, The Cancer Journals, black feminist lesbian poet warrior, Audre Lorde writes, “With quick cosmetic reassurance, we are told that our feelings are not important, our appearance is the all, the sum total of self.” (Lorde 58). The implication is that if a woman looks "whole" than she is whole. Preserving her appearance preserves her to be the same as before, irrespective of the impact cancer has had on her life.

Reconstruction after mastectomies or the use of a prosthesis can easily become a mechanism of the politeness of pain, a concept whereby those in pain feel pressured to downplay their suffering to the benefit of others. Hiding mastectomies and maintaining outward "normality" for the comfort of others can function as an example of this. 

During Audre Lorde’s experiences with breast cancer in the early 1980s, she was strongly encouraged to hide her mastectomy through the use of a prosthesis. When she tried to forgo this convention she was chastised. 

In her book, Audre Lorde reflects on her first post-op doctor’s appointment, to which she did not wear a prosthesis. The nurse chastised her, saying, “You will feel so much better with it on” “And besides we really like you to wear something at least when you come in. Otherwise its bad for the morale of the office” (Lorde 60).

It is crucial to note that there are  women who choose prosthesis or reconstruction surgeries freely, and that is completely their right. The issue arises when outside sources pressure or guilt women into these measures as a way to look “normal” or “get over” their cancer.

Audre Lorde wrote about her experience in the 1980s and yet today in some areas, very little has changed. In areas where the tides are slowly changing for women post-mastectomies,  it is primarily because women have fought to claim space for themselves and autonomy over their bodies.

Today about 25 percent of double mastectomy patients and 50 percent of single mastectomy patients choose to stay flat after the surgery. However, these women often still need to fight against doctors or friends and family when they decide to keep their chests flat.

Rachel D. Cohen advocating for Not Putting on a Shirt

Rachel D. Cohen, author of FLAT: Reclaiming My Body After Breast Cancer  writes about her experience with a doctor who encouraged reconstruction with a highly invasive technique which involves cutting the largest muscle in the back and creating flaps out of it. The doctor assured Cohen that most women never miss “the largest muscle in their back”.  Cohen writes, “this idea that we don't need our body strength, that we don't need to be strong because what's more important than strength is presenting to the world as having breasts, is really disturbing to me. And it was assumed that I would much rather look quote-unquote "normal" in clothes, that that would be my priority over feeling strong and confident in my body. So the only people this rebuilt breast would be for would be strangers.”

Rachel Cohen had to argue against the surgeon to choose to be flat-chested. To decide for herself how she wanted to live. Even when they advocate for themselves, some women’s voices are being ignored and their bodies are altered without their consent. Others believe they know what’s best for the woman, and decide how she should look for her.

Cohen reports on how some surgeons decide for themselves during surgery to leave extra skin on a woman’s chest, even after she decided to go flat. They leave these “pouches” of skin in case a woman “changes her mind” and decides to get implants and reconstruction later. This is a blatant violation of a woman’s autonomy and often leaves women with sagging skin that they must get additional corrective surgeries on, which their insurance often won’t pay for, calling it cosmetic. This is an outrage to women’s bodily autonomy and is unacceptable. Cohen is involved in a grassroots advocacy group called "Not Putting on a Shirt" which advocates for compliance with a woman's wishes and is currently doing more research on the prevalence of these violations of care compliance. They are working to bring voice to this issue.

Audre Lorde wrote, “Silence and invisibility go hand in hand with powerlessness” (Lorde 62)

With very little thanks to the pressures of society, many women are fighting past that silence and invisibility and reclaiming their bodies and their voices after breast cancer and mastectomies in new ways.

There are Facebook pages, such as “Flat and Fabulous” where women post outfit photos of themselves and share encouraging words and advice. Among the comments are many from women who elected to have their breast implants removed after reconstruction and go flat after the fact.

Another way in which some women are reclaiming sovereignty over their bodies and body image are chest tattoos. Nicole O’Hara decided that rather than trying to recreate her nipples and exact appearance of her breasts after her mastectomy, she would be more artistic and receive a tattoo. A short video of her tattoo experience can be found here. 

O'Hara's finished tattoo

Screenshots of the video of O'Hara's experiences

O’Hara specifically decided to have a portion of the tattoo extend higher up her shoulder and beyond her shirt so “she could tell her story to anyone who happened to see it”.

Lorde did the important work of being an advocate for giving women with breast cancer the space and agency to fully grapple with the impacts of breast cancer in their lives. Breast cancer is not an aesthetic issue; it is an issue that forces many women to face their mortality. Women must have the space to process this in their own way. They should feel no pressure to seek a "normal" appearance and silence their journey for the sake of others comfort or desires. As Lorde so eloquently wrote, "Any short circuiting of this quest for self-definition and power, however well-meaning and under whatever guise, must be seen as damaging, for it keeps the post-mastectomy woman in a position of perpetual and secret insufficiency, infantilized and dependent for her identity upon an external definition by appearance” (Lorde, 59)

Rachel Cohen asserts, “I'm not anti-reconstruction; I'm pro-information.” Reconstruction is the right choice for some women but not others. The point is that a woman should feel complete autonomy over her body and her choices. She should not be made to feel that the appearance of her chest defines her identity. There should be a strong emphasis on supporting a woman’s mental and spiritual journey through cancer, not just her physical journey. Amidst the challenges, hardships, and pain of cancer treatment, societal opinions about appearance and aesthetics should be secondary.

Class text:
Lorde, Audre. The Cancer Journals. San Francisco. Aunt Lute Books. 1997