Boob Boxes: Post-Mastectomy Prosthetics and the Artifice of Breast Cancer

Author: Dr. Holly Walters, a cultural anthropologist at Wellesley College, United States. Her work focuses on religious experience and ritual practice in South Asia. Her current research addresses issues of political practice and ritual mobility in the high Himalayas of Mustang, Nepal among Hindu and Buddhist pilgrims who venerate sacred ammonite fossils, called Shaligrams. Holly is a regular contributor to TFS. Find more about Dr. Walters’ work on Shaligrams and especially her latest book release on her blog, Peregrination.

In August of 2018, only weeks after defending my dissertation and graduating with my PhD, and just a month shy of my 38th birthday, I was diagnosed with breast cancer. It was the worst possible news at an even worse time. My tumor was large and aggressive. I would need to start chemotherapy immediately. We wouldn’t know if it had spread into my lymph nodes until surgery. Furthermore, that surgery, scheduled for that upcoming December, would certainly take the entirety of my left breast and we would need to talk about the right (keep it and monitor with bi-yearly mammograms or take it off at the same time). Also, I was in the middle of writing my first book because I needed to keep up a publication schedule for job interviews and teach my two adjunct classes if I wanted a paycheck. I was on the academic job market and had no health insurance.

A perfect storm

Those first few tumultuous months are now a blur. Weekly drives into Boston for four-hour infusions. Even more visits to various oncologists and surgeons and other specialists for imaging, examinations, and medications to control the overwhelming side-effects of the drug cocktail that would hopefully tame the 3cm tumor enough to safely remove. All the while I was editing articles and grading student essays while pulling out chunks of hair, or trying to finish chapter paragraphs through bouts of nausea (I even have a story about losing most of my eyebrow once during office hours, but I’ll spare you).

You might ask, of course, why I would do all of that at the same time; teach and write and grade while battling cancer. Short answer? There wasn’t any other option. It wasn’t “bravery.” I had to work. No classes meant no income. No income meant no treatment, or food, or transportation, or anything else. No writing meant no publications. No publications or teaching meant no job prospects and on an already teetering academic market, per-class adjuncting is precarious as precarious gets. In the end, I simply couldn’t afford not to do it. And with treatment bills mounting into the tens of thousands, even with my husband’s (reasonably good) insurance, it was that or resort to relying on the goodwill of a nonexistent rich benefactor.

It will, however, never cease to amaze me that I managed to surpass my own total student loan debt (BA, MA, PhD combined!) with less than two-week’s worth of chemotherapy. To give you an idea, the line-item bill for one (ONE) IV bag of the standard medication I was on to shrink the tumor (not including procedure fees or port access) came in at around $55,000 USD. Each week of twelve weeks of initial treatment involved four of those.

Welcome to Cancerland

Years ago, I had actually already read Barbara Ehrenreich’s “Welcome to Cancerland” (Harpers, 2001). A wonderfully witty polemic on the “cult of pink kitsch” that simultaneously infantilizes breast cancer patients through “cutesy” merchandising while suppressing their very real experiences of fear, pain, sickness, loss, and mortality. This extensive kind of corporate breast cancer culture, as Ehrenreich calls it, not only posits that one can essentially “consume for the cure” but also sets out to literally accessorize the worst moments of a person’s life. Pink bandanas to cover the bald head, glittery bracelets with enamel pink ribbons so you can “feel pretty,” fluffy pink mittens, and other “brighten up your day” kinds of knick-knacks.

“The Susan G. Komen Foundation is headed by breast-cancer veteran and Bush’s nominee for ambassador to Hungary Nancy Brinker. Komen organizes the annual Race for the Cure©, which attracts about a million people—mostly survivors, friends, and family members. Its website provides a microcosm of the new breast-cancer culture, offering news of the races, message boards for accounts of individuals’ struggles with the disease, and a “marketplace” of breast-cancer-related products to buy.” (pg. 46)

I also experienced this and, to be completely honest, it still induces rage. I didn’t need baskets of fuzzy socks, toys, or scented candles to make my “experience” better (nothing makes chemo better). What I needed was help paying for groceries, light meal-prep assistance, someone to put gas in my car, maybe cover a utility bill or two, and some serious deadline extensions. Even now, a year out from the end of my treatment, I have a closet full of pink paraphernalia I’ll never use.

What has also stayed with me though is her line: “The infantilizing trope is perplexing. Certainly men diagnosed with prostate cancer do not receive gifts of matchbox cars.” (pg. 47)

During treatment I also chanced upon Catherine Guthrie’s “Flat: Reclaiming My Body from Breast Cancer.” In this memoir, a queer woman sets out to not only survive a life-threatening illness, but to do so on her own terms. Which means, in this case, advocating for the right to choose a complete, bilateral, mastectomy without reconstruction. To go completely flat and to stay that way. To have her breasts removed and to not have to get them back.

It might surprise you to learn that this is still quite difficult. We live in a culture that idolizes feminine breasts and finds the idea of voluntarily removing them (cancer or not), abhorrent. And if they must be removed (as it turned out was my case), then they must be replaced with what my plastic surgery consultation gleefully explained would be “the breasts of my dreams.” This was followed by lengthy explanations of the multiple following surgeries and hospitalizations I would require for either implants or for what’s called a DIEP flap; the grafting of a large portion of my abdominal fat onto my chest and then re-shaping it. The resulting “breast-like mound” would never have any sensation though, of course. And they wouldn’t have nipples either. They were really just there to make my clothes fit properly, and wasn’t that just wonderful!

Boobs in a box, never worn

If you’ve undergone this process, please forgive my sarcasm. This is in no way meant to shame anyone who has had reconstruction. The relationship each of us has with our bodies is complicated and anyone who chooses implants or grafts in order to be comfortable in themselves, to feel whole again, or because they are an integral part of their self-image and sexuality has made the absolute right choice. Period.

I chose to go flat. But I almost wasn’t allowed to.

My breast surgeon was unsure. My plastic surgeon tried several times to talk me out of it (with the familiar rhetoric of “regret”). My parents were concerned. My in-laws were uncomfortable. And everyone else really seemed to like commenting out loud about whether or not my husband would ever find me sexually attractive again. All the while, here I was, far more upset about losing all of my hair than I ever was about losing my breasts. The baldness made me actually look sick and changed everyday interactions in some of the worst ways. But even now that my hair has grown back, many people still don’t seem to know how to react to me; as though my breastless but still mostly feminine shape doesn’t quite add up with my clothing and presentation.

This is largely due to the unacknowledged psychological tension that underlies deeply gendered illnesses: that it is possible to have one’s gender or sex taken away by disease or disability; literally eaten by cancer and its aftermath. The sick person is then framed as one who has been robbed of the “natural” trappings of motherhood, wife-dom, and feminine sexuality. The aesthetics of breast cancer therefore remained fixated on a loss of idealized womanhood.

What is more, as I continued to think about it, I had never had a good relationship with my breasts. They were big and had been big since before I was a teenager. They weren’t a source of identity for me and I didn’t particularly enjoy them. Perhaps it is even fair to say that my own somewhat ambiguous sense of gender and my current genderfluidity helped me out in the end. The cancer meant I was going to lose them both to save my life and, even though I waited patiently for the dysphoria, revulsion, and the body-hatred to set in once they were gone, it never came. The “regret” I kept hearing so much about just failed to materialize. So, I didn’t ask for them back.

Ironically, American health insurance, by law, must either pay for reconstruction or it must pay for prosthetics. As a result, I am now the owner of two very realistic latex-silicone breasts that are both color-matched to my skin tone and formed to the curves of my chest. They fit into a neat little bra and actually do look totally natural once everything is adjusted. It’s impressive, but you know what? They’re just not me.

I got them because, well, I figured I should. At the time, I still thought I might suddenly want them or would need them to make myself feel like myself. But, that didn’t happen either and I’ve actually never worn them. They sit in the back of my closet, in their demure little pink-velvet boxes with the flowers on top, right next to the rest of the pink detritus I’ve collected over the past two years.

Today, I remain completely flat. My chest is smooth and featureless (save for the pale white lines of the scars that cut completely across my pectorals). I have reclaimed my body with a full chest tattoo instead; done in an intricate blue-woad painting style. It’s absolutely beautiful and, for the first time in my life, I’m happy to show off my chest in low-cut tops or just plain bare. Last summer, I even went outside without a shirt on.

It was amazing.

[The image of the pink ribbon is by Angiola Harry sourced from Unsplash.]

[The image of the IV drip is by Marcelo Leal sourced from Unsplash.]

[The image of the doll with pink flowers and ribbons is by Ann sourced from Unsplash.]

[The image of the breast implants is by Philippe Spitalier sourced from Unsplash.]

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