Guest Editorial Symposium on Women's Health

Archives

home > archives > 12/2 > Guest Editorial Symposium on Women's Health

Guest Editorial

Symposium on Women's Health

Breast health

Lynne Hunt
Centre for Public Health and Medical Education, Edith Cowan University, Western Australia

Beverley McNamara
Senior Lecturer Anthropology and Sociology, School of Social and Cultural Studies, The University of Western Australia

Article Text

'Y'know Mum, those breasts of yours have been really good to me. They fed me for three years' ... 'Well yes, AND they fed me for 18 months'. Their father looks across at me and smiles. 'I think we've all had a lot of pleasure from these breasts', he says.

These words from the two daughters and the partner of a woman, newly diagnosed with breast cancer, taken from one of the papers that follow, serve to remind us that breasts are heavily invested with social significance. They feed babies, inspire lovers and artists, get cancer, cause body-image anxieties, and contribute to personal identities that must be reconstituted following mastectomy.

The focus of this special symposium on women's health in Health sociology review is on a particular body part: breasts. As such, it speaks to women's lives and to some of their joys and their greatest fears. In the symposium of papers presented here we see revealed the interrelationship between culture, breasts, life stories and health care. The significance of culture can be most readily gleaned in Debbi Long's paper on cross-feeding among Australian women. She shows that in Western society, infant nutritional advice to mothers that 'Breast is Best', actually implies that only the natural mother's breast is best. Mothers and health care professionals alike reject cross-feeding. Yet in other societies breastfeeding other women's babies is a common practice. Long contextualises the aversion to this practice in terms of Western social constructions of the isolated mother-child relationship. However, despite the general rejection of cross-feeding, Long also finds some women do secretly feed other women's babies, their silence on the issue confirming the clearly demarcated boundaries of what is 'normal' in regard to breast milk.

From the focus on breasts as life-giving, the next two papers, by contrast, show the heart-rending link between breasts, cancer and mortality. Breast cancer has been identified as a significant cause of the untimely death of Australian women, with its incidence high in comparison to other forms of cancer. Bethne Hart's paper takes breast cancer as a point of departure to explore human finitude and the social management of human mortality. Hart suggests that the issue for women is death rather than breast cancer or breasts per se. Indeed, some women in her study felt that they were perceived as 'dead woman walking' by virtue of the cancer inscribed upon their bodies. Her paper contributes, not just to the special edition on breast health, but also to the literature on human mortality, which, she suggests, has received little sociological or theoretical attention, and even less gender analysis. She writes of a health care profession focused on cure and management in a manner that suppresses concerns about human finitude. Similar notions of suppression are endorsed by Katrina Breaden in her study of younger women with breast cancer. Breaden argues that 'the biomedical literature silences this "face" of advanced breast cancer in younger women. It allows no space in which the nature of tragedy can be revealed and critiqued'. Young women with advanced breast cancer are not supposed to die, and yet, as Breaden's paper illustrates, they do face this reality and the even greater tragedy of leaving their young children to grow up without them. She asks how can the discourse of tragedy be unmasked so that young women with breast cancer can be eased gently through the final process.

'The good news is that you won't die of this. The bad news is that you will have to lose a breast.' Lekkie Hopkins' autobiographical paper directs attention away from death and dying to the experience of mastectomy. Identifying breast cancer as a social drama (Broom 2001) Hopkins draws on a variety of sources to 'story' her own personal version of events. 'Two arms two legs one breast one nose one mouth two eyes two ears ... how do I story the raw life of this?' She speaks of complex intertwined stories in which she seeks to overcome slick narratives of the courageous survivor and a body disfigured by mastectomy. As readers may find, Hopkins' surprisingly upbeat progression to loving her single-breasted body is likely to give us all hope, for no doubt it is a courageous portrayal.

Samantha Crompvoet's article on breast reconstruction follows Lekkie Hopkins' narrative, fitting neatly, and literally, into the gap left by the missing breast. In 'Reconstructing the self: Breast cancer and the post-surgical body', Crompvoet shows that there is little opportunity for women who have had a mastectomy to 'reconceptualise their bodies as normal or feminine without breasts'. Breast reconstruction offers renewed femininity, sexuality and normalcy. Post-mastectomy choices, Crompvoet argues, must be reconceptualised so that women can 'accept and love their bodies one-breasted, two-breasted or no-breasted'. As with so many of the other papers in this special issue, we see that women are constrained by narrowly conceived notions of womanhood, femininity and motherhood.

However, the concept of normalcy can itself be contested as Yoni Luxford does in her paper on benign breast disease. 'Troublesome breasts' are not life- threatening, there has been no mastectomy, yet the perceived risk 'disrupts the notion of a previously predictable and familiar relationship with the self/body'. Benign breast disease engages women in ongoing surveillance which 'ensures that the body remembers'. Using a case study approach, Luxford shows how even breast self-examination 'constructs ... breasts as dangerous territory in a very negative way'. The paper is of critical relevance to women as they engage with health promotional messages and advice from health professionals and as they traverse the uncertain territory of 'troublesome' breasts.

This symposium in Health Sociology Review not only provides a focus on breast health, it also raises methodological issues about the use of narrative in sociological research. All of the articles are based on qualitative research, often relying on the use of case studies and narrative. Perhaps this is not surprising given the intimate nature of the topic. Indeed, Lekkie Hopkins' article extends the use of narrative to autobiography and, in so doing, stresses intimacy with:

personal archives and memories ... literary genres, including poetry and stream-of-consciousness creative prose, in order to reflect on the process of moving from the non-articulated raw life of a bodily and psychic experience into the discursive space of communicating some dimensions of that experience to others.

The inclusion of an autobiographical article in Health sociology review results in this editorial wrestling with the same issues as an earlier editorial in Sociology (1993: 1). It confirmed that sociologists customarily analyse lives through ethnography and interviews, and that well-established sociological concepts 'can readily be seen as dealing with biographical practice'. Even so, as Dorothy Smith (1987: 110) indicated, sociologists can listen to people's description of events but they 'cannot rely upon them for an understanding of the relations that shape and determine the everyday'. Much hinges on the definitions of biography and autobiography. In accepting both as part of the sociological endeavour, the Sociology editorial concluded that the acceptance of autobiography, 'means rejecting any notion that 'a life' can be understood as a representation of a single self in isolation from networks of interwoven biographies'. We take this position in this issue of Health Sociology Review, but there also remains the matter of selectivity. Biographers and autobiographers both select material to create an image and make a point-the single tale rings true to others, and even the anomaly serves to contrast and instruct. Sociologists also create images, make points and even, at times, instruct: they are active agents in the production of sociological knowledge. We are encouraged here to use our sociological imaginations to embrace biography, history and social structure, and indeed to engage with the intimacy of the one-breasted, two-breasted, no-breasted body.

The articles in this symposium provide opportunities to explore the boundaries of the sociology of health as it pertains to particular body parts- breasts. The journey is both informative and emotionally engaging. It offers interpretive respect for women's words while explicating the social world of breasted experience.

Toggle references