On February 4, 2020, my breasts were surgically removed via bilateral mastectomy.
This was my fourth surgery in three months following a diagnosis of cancer in my right breast in October 2019. I was 40 years old. Though I briefly considered breast reconstruction, I knew instinctively that I could not tolerate a reconstructed breast, not to mention all of the additional surgeries and healing time that assembling it would require. And once I came to terms with losing my right breast, the thought of living with one breast seemed somehow worse than having no breasts at all. Electing a bilateral mastectomy with aesthetic flat closure just felt right, so that is what I chose.
Given all of the symbolic freight that breasts carry in Western culture, the loss of my breasts forced me to reckon with my identity as a cisgender woman. What would it mean to suddenly live without breasts for the first time in decades? How would I cope with an upper body no longer recognizably female or male, with twin seven-inch scars taking the place of more legible anatomical features? On a day-to-day level, would the kindly older man who waves or nods a friendly hello when I pass him on my morning runs think I look funny? Versions of this last question, in particular, ate at me, as vain as it might sound. I suppose what I questioned was whether I would still feel capable of moving through the world as a woman, with ease and confidence (to whatever degree that this is ever an attainable goal).
As a university professor who specializes in eighteenth-century literature and culture, my research quickly became one of the lenses through which I processed these questions. I thought about the novelist Frances Burney’s harrowing account of her single mastectomy, without anesthesia, in 1811, though I could not bring myself to reread it until many months after my own surgery. Her strong desire to shield her husband from her trauma, which I did not even remember being part of the story, now stands out in sharp relief, for I watched through a haze of morphine as my own husband fainted in my hospital room when a nurse checked my surgical incisions and drains a few hours post-op. I also thought about Pamela’s debates with her husband about whether or not she should breastfeed their son in the sequel to Samuel Richardson’s 1740 novel Pamela, her breasts the locus of their power struggle. More broadly, I thought about the role breasts play in the eighteenth-century’s imposing gender edifices, as body parts increasingly viewed as constitutive of female identity in their association with motherhood. The eighteenth century has long been central to how I think about the world, so I suppose I looked to it to understand my grief and my fear about continuing to be a woman in a body now otherwise.
Above all, I thought about Lady Delacour from Maria Edgeworth’s 1801 novel Belinda. At the beginning of the novel, the young Belinda Portman goes to live in London with the witty, charming, and beautiful Lady Delacour at the behest of Belinda’s matchmaking aunt Mrs. Stanhope, who hopes that by circulating in Lady Delacour’s fashionable circles, Belinda will find a suitably wealthy husband. Belinda soon learns that Lady Delacour’s gay public behavior is a ruse. She is miserable with her spendthrift drunkard of a husband, whom she married to provoke her first love, and is alienated from her daughter Helena, whom she sent to a wet nurse after her “sickly” first daughter died while still an infant. Helena now lives with a different family.
Lady Delacour’s breasts are at the center of her misery—one breast in particular. In addition to her domestic strife, Belinda learns that Lady Delacour hides a terrible secret: an addiction to opium, which she takes to manage the pain of a grievous wound to her breast, sustained when an overcharged pistol recoiled during a duel with her social rival “the odious Mrs. Luttridge” (a description that endlessly amuses me). Lady Delacour attended this duel dressed as a man and accompanied by her outrageous and beguiling friend Harriett Freke, for whom she seems to feel a deep attraction and at whose encouragement she carried on a prior flirtation with a Colonel Lawless. In the misery brought by this “blow” to her breast, her guilt over Colonel Lawless’s death in a duel with her husband, and her subsequent abandonment by Harriett Freke, Lady Delacour devotes herself to “a constant course of dissipation” for the remainder of her days, expecting her breast to kill her in due time. In telling Belinda her story, Lady Delacour makes clear that her series of “unnatural” behaviors—extramarital flirtation, same-sex attraction, cross-dressing, and engaging in masculine combat—are manifest in the “hideous spectacle” of her breast.
Belinda, for her part, determines to make a “domestic woman” out of Lady Delacour—to reunite her with Helena and reconcile her to her husband. True to the expectations of an eighteenth-century readership, Belinda succeeds by the novel’s end with the help of her suitor Clarence Hervey. Though Lady Delacour briefly determines that she must “submit to the dreadful operation which alone can radically cure me” (a mastectomy, and without anesthesia), this surgery proves unnecessary. Honesty and submission turn out to be the only necessary courses of treatment: as Lady Delacour gradually allows herself to experience and show affection for her husband and daughter, her breast heals apace. Lady Delacour ends the novel in tableau with her family, healthy and happy, a scene that the narrator terms “quite pretty and natural!” In Belinda, then, the message could hardly be clearer: failing to live as a properly domestic woman will kill you, and your breast will be the executioner.
As I awaited my own “dreadful operation,” Belinda’s equation of Lady Delacour’s womanly failures with her “hideous” breast nagged at me, for my diagnosis brought me face to face with my own perceived failures in this area. Perhaps here is where I will say that I am not a mother; while they still existed, my breasts never nourished anyone. The finality of their loss is difficult to confront in part for the other negations it carries—for those experiences that will remain forever closed to me, for those possibilities now (quite literally) amputated from my future. Their loss also brought me to entertain the idea that not having children might be one reason why I developed breast cancer in the first place. “It is well established that childless women and women having children later in life are at an increased risk of developing breast cancer,” intoned doctors representing the Institute for Cancer Research in London in 2007. This is one of the first things that entered my mind when, sitting at my desk with a lukewarm cup of tea, my doctor’s office called with my biopsy results. Given that I have no family history of breast cancer, am relatively young, and was considered low risk for the disease, my childlessness seemed at fault. If I were a mother, this would not have happened. Though I tried to resist it, I kept circling back to this self-accusation as I sought to explain the inexplicable.
I realize that it might seem absurd to blame myself for my breast cancer, but such is the formative power of narrative. If there is anything one learns from the eighteenth-century novel, after all, it is the death sentence—actual or symbolic—that comes when women fail to meet domestic expectations, which generally include successful motherhood. In other words, I suppose I am precisely the kind of female reader that eighteenth-century novelists like Samuel Richardson imagined: susceptible to cautionary tales.
At the same time, however, my years as a student of the eighteenth century also prompt me to look for the cracks that form around even the tidiest of endings. At the conclusion to Belinda, Lady Delacour places all of the novel’s characters “in proper attitudes for stage effect,” musing, “What signifies being happy, unless we appear so?” Increasingly, when I think about Belinda, I think about the fact that Lady Delacour must stage her happiness—as though the novel means to remind us that such “pretty and natural” stories are not actually so, and that they might crowd out other ways of being in the world.
As I search for different stories to think through, a more recent fictional woman who experiences breast cancer emerges as a life raft in the waters of self-recrimination: Samantha Jones from HBO’s Sex and the City. Samantha is the show’s sex-positive icon who never marries or has children, and proudly so. When she develops breast cancer in season six and learns that she must undergo a round of chemotherapy following her lumpectomy, she voices the confusion with which I, too, have struggled: “I don’t understand how this happened to me.” When her doctor suggests that it might be the result of “lifestyle choices,” such as not having children, she snatches her medical chart out of his hand, storms out of the examination room while still in her open-front patient gown, and determines to find a new doctor—a scene that I now find deeply cathartic. Recounting the visit over lunch, Samantha fumes: “He said I’m a whore who deserves chemotherapy.”
When Samantha hears It’s your fault, however, her reaction isn’t reformation, it is entrenched resistance. Unlike Lady Delacour, Samantha refuses to play the part of the domestic woman, and this refusal is not a death sentence; though her treatment is harrowing, Samantha heals. She survives her cancer without penance for any of her “lifestyle choices,” and her reward is precisely the life that she desires and deserves, filled with passion, fulfillment, joy, and love—though not with marriage or parenthood. For all of the show’s many problems and otherwise normative impulses, which I fully acknowledge and will not defend, Samantha’s breast cancer arc is an affirming reminder that I can grieve my losses without grieving my life. I like to think of her as the eighteenth-century’s negative exemplar turned heroine (she is Vice Rewarded, if you will), and she convinces me that there are other stories we can tell about bodies and their significations.
As I page through the manilla folder containing my hospital bills and post-surgery reports, which I do from time to time, I find myself seeking a different kind of narrative about breasts—one that vacates some of the symbolic power on which the eighteenth-century novel insists. I am particularly drawn to the report issued after my mastectomy. It precisely details the weight, diameter, and color of my excised breasts in toto, transforming them into pure physiology: “The remainder of the breast parenchyma is composed of approximately 75% dense pink-white fibrous tissue and 25% tan-yellow lobulated adipose tissue.” When I read this sentence, I cannot help but picture my breasts resting indifferently, side by side, on a cool steel tray, no longer having anything to do with me. In this vision they become what they were all along: blood, tissue, skin, and nerve endings. Matter, not sign.
What else can my body mean? I wonder as I massage vitamin E oil into my tender scars every evening. Perhaps I might see my now-breastless body not as lacking, but as liminal; not as lesser, but as something else. Perhaps I might see my life in these same terms. A few days before my mastectomy, a dear friend sent me a consoling message, which read in part: “you are so much more than your breasts.” She was right. My breasts were part of me, but I exceed them. And I’m still here.
Angela Rehbein is Associate Professor of English at West Liberty University in West Virginia. She co-edited Women’s Literary Networks and Romanticism: “A Tribe of Authoresses” (Liverpool UP, 2017) with Andrew Winckles and has also published articles on the Romantic-era writers Jane West and Elizabeth Inchbald.