Breast cancer can redefine what it means to be a woman

For some women, losing their breasts means losing part of their identity. For others, it’s the price of staying alive. And for women carrying a cancer-risk gene, preventative surgery means confronting difficult questions about their bodies, femininity, and futures. 

For South African Jewish women Sue Blumberg, Dani Bitton, and Debbie Firer, breast cancer and preventative surgery have literally shaped their understanding of what it means to be a woman. Their experiences show that there is no single way to navigate the physical and emotional changes that follow treatment. 

Blumberg’s experience spans three generations of women in her family. She inherited the BRCA1 gene mutation from her mother, Shirley, who inherited it from her mother, Sylvia. Both generations faced breast cancer before genetic testing became available to inform their decisions. 

Blumberg was diagnosed with breast cancer at 48. She underwent a double mastectomy, breast reconstruction, chemotherapy, and a preventative hysterectomy. 

Removing both breasts brought her relief because the cancer was gone. She told the SA Jewish Report that chemotherapy was the most difficult part of treatment because it left her feeling sick, weak, and exhausted, preventing her from practising as an architect and caring for her family as she wanted. 

She has three daughters and had been married for 25 years when she received her diagnosis. She felt sure of herself and her femininity before treatment. “I was pretty confident in who I was and how I was in the world,” she said. 

Her reconstructed breasts resemble her original breasts, allowing her to continue wearing her usual clothes. However, she emphasised that reconstruction doesn’t restore everything removed during surgery. “They are an imitation of your breasts, but they’re not your breasts.” 

Removing breast tissue can mean losing sensation in the area, and the physical experience of reconstructed breasts is different from having natural breasts. Nevertheless, Blumberg didn’t feel that her identity as a woman had changed. She was relieved to have survived and grateful to watch her children grow. 

Her understanding of femininity was also shaped by her mother and grandmother. Both women faced cancer and demonstrated confidence despite the physical changes they experienced. “They were very good role models,” she said. 

Her daughters Sarah and Gabriella also tested positive for BRCA1 and chose preventative double mastectomies. Women who undergo surgery before developing cancer are sometimes called “previvors”. Their experiences differ from those of women diagnosed with cancer, although both groups can face difficult feelings about their bodies and futures. 

Gabriella explored these questions in a poem about her genetic inheritance. She reflected on the connection between her grandmother’s experiences, her mother’s pain, and her own decision to undergo preventative surgery. “Lose my femininity/ Rush to a pregnancy/ Question my identity” she wrote, questioning what it meant to remain a woman after removing parts of her body. 

Her poem also explored the fear of losing her ability to breastfeed and the uncertainty surrounding her identity. Yet she ultimately described her inheritance as a connection to generations of women whose strength had shaped her. 

Gabriella tested positive for BRCA1 at 18 and chose surgery at 26. In between, she underwent regular monitoring and researched her options before approaching breast and plastic surgeons. 

For Bitton, a performer diagnosed with aggressive breast cancer in her 30s, the prospect of losing her breasts was frightening. She was playing her dream role of Evita in China when she discovered a lump in her breast. 

After returning home, she was diagnosed with stage two, grade three breast cancer. Testing revealed that she carried a BRCA2 gene mutation. She underwent a double mastectomy, chemotherapy, and radiation. Before surgery, she held a personal ceremony to thank her breasts for serving her well. “I held them for one last time and then I could feel the lump inside,” she recalled. 

Bitton described the operation as a significant loss of sensuality. She also feared losing her hair, which she found more frightening than losing her breasts. She eventually reframed chemotherapy as medicine rather than poison. When her hair began falling out, she chose to see shaving it as a symbol of healing. “I felt so liberated,” she said. “I was on the other side of my biggest fear.” 

Bitton has since learned to accept her reconstructed body. She still feels sexy and believes the right partner will value her beyond her physical appearance. Her scars have become reminders of what she’s survived. She writes and speaks publicly about her experience to help other women understand what treatment can involve. “Vulnerability wasn’t actually my weakness,” she said. “It became my superpower.” 

Firer’s experience offers another perspective. She was diagnosed with breast cancer in 2003, following her sister’s diagnosis 18 months earlier. Her family already knew about its inherited cancer risk after an aunt tested positive for BRCA2 following an ovarian cancer diagnosis. 

Firer underwent a double mastectomy, chemotherapy, and radiation. She was diagnosed with a recurrence in 2024 and underwent further treatment. Subsequent scans showed that she was clear of cancer. 

She said she hadn’t considered refusing a mastectomy because of concerns about her appearance. She regarded surgery as the best way to protect her health. “Losing my breasts was a big deal for me, but I try not to dwell on it,” she said. 

Her children were four and seven when she was first diagnosed. Getting through treatment and remaining present for them took priority over her concerns about femininity. However, reconstruction hasn’t restored her body to how it was before surgery. She has undergone repeated reconstructive procedures and continues to experience physical changes. 

Firer also underwent a hysterectomy and took tamoxifen, a hormone therapy used to reduce the risk of breast cancer returning. Its side effects, including hot flushes and weight changes, presented additional challenges. 

She continues to make an effort with her appearance. “I always say if you look good, you feel good,” she said. 

These three women share the determination to make decisions that allow them to live on their own terms. 

Blumberg believes women must have the freedom to decide whether reconstruction suits them. She encourages patients to prepare questions and seek advice before surgery. “When you’re diagnosed with breast cancer, you’re so frightened that you’re not going to survive, that you can’t think 100% clearly,” she said. She recommends taking a trusted person to medical appointments. 

The BRCA1 and BRCA2 genes normally help suppress tumours by supporting DNA repair. Certain inherited mutations can increase the risk of breast and ovarian cancer. These genes affect both sexes, and individual risk profiles differ. 

Genetic counselling can help people understand their personal risks and available options. A positive result doesn’t mean someone will inevitably develop cancer, nor does it mean everyone should choose the same preventative measures. 

For women confronting these decisions, the relationship between breasts and femininity can be deeply personal. Surgery may bring relief, grief, uncertainty, or a combination of emotions. 

Blumberg has also explored her cancer journey through art, using her work to open conversations about the physical and emotional challenges of a mastectomy. 

The stories of Blumberg, Bitton, and Firer show that femininity cannot be defined by breasts, hair, or a particular appearance. Nor does surviving cancer require women to feel positive about every change to their bodies. Their journeys are different, but each reflects the importance of informed choices, personal support, and the freedom to define womanhood for oneself.