By Adrienne Kapstein
On my morning trudge to the subway the other day, I passed a poster of an assorted group of cool, edgy musicians. One celebrity posed wearing an outfit with an artfully placed pastie of what appeared to be duct tape, but on further reflection, was probably leather, over her nipple. Apart from the nipple being concealed, the rest of her breast was visible. Did the fact that the nipple was covered mean her breast wasn’t fully revealed, I wondered?
Facebook will sometimes censor posts that show breasts with nipples, but doesn’t censor images on the double mastectomy group of which I am a member. A group where brave women share pictures of themselves post-surgery, nippleless, with scars in their place. Do the Facebook monitors consider these not to be breasts if there is no nipple?
A brief survey of Western art history reveals endless depictions of breasts with nipples suckled,(1) bitten, tweaked, pinched, poked, groped, squeezed, sniffed, twiddled, delicately draped and yet fully revealed.
Is the nipple what makes a breast, a breast?
I’m asking because 11 months to the day I am writing this, I lost my breasts. That sounds careless. 11 months to the day, my breasts were taken from me. That doesn’t sound quite right either. They weren’t stolen, in fact; much to my horror, I had to grant permission. 11 months to the day, my breasts were removed. There. As cold and ruthless as it sounds. 7 months and 19 days ago I had “exchange” surgery to replace temporary “expanders” that stretch the muscles with implants. I was not a candidate for a nipple-sparing mastectomy, and so they were removed too. Now, almost a year out, I am left with the decision “to nipple, or not to nipple.”
The visible breast is made up of the nipple and areola. The English word areola comes from the Latin areola, diminutive of area – open space. An open space. This captures how I feel right now. Inhabiting an open space. Existing in the open space between the before and after of cancer; the open space between mourning the body I had for 48 years, and accepting a new one. The open space between having a breast mound, but no nipple. And therefore, the open space between, do I really have breasts, or not?
Diagnosed with invasive ductal carcinoma and with the pre-existing condition of lobular carcinoma in situ (LCIS) (which is not considered cancer, but are cells with a high chance of becoming malignant), I was given the excruciating choice to opt for a lumpectomy and radiation or a mastectomy. It feels like an impossible task to try and remember the avenues of research and self-reflection and anxiety and sadness I navigated during that time. So, to avoid that and summarize: There was no way of knowing how large an area of breast would need to be removed by lumpectomy, and with small breasts and the location of the cancer, I feared major physical deformation. Radiation would further complicate things – damage the skin and shrink the remaining breast tissue. Additionally, with the LCIS diagnosis, there was the strong possibility that more cancer would develop (I had already had 5 biopsies before the cancer was found), and my breast and skin would be significantly compromised with radiation, possibly meaning that I might not have the choice for reconstruction if needed in the future. After much agonizing, I made a decision I never would have dreamed of making. In fact, previous thoughts of mastectomies gave me visceral adverse reactions that made me feel physically ill.
Jump-cut in time and emotion: I now have implants. Although the surgeries went smoothly, I healed fast, and every medical professional compliments me on how “good it looks,” I have what can be best described as Barbie boobs. Too hard, too round, and nippleless. (Spell check does not like this word. Well spell check, neither do I.) But without nipples, my breasts are blank. When I see myself naked, I feel a little like an alien. Wearing a bra helps because it hides the missing part and tricks my brain.