Mary K. DeShazer, Mammographies: The Cultural Discourses of Breast Cancer Narratives

Mary K. DeShazer, Mammographies: The Cultural Discourses of Breast Cancer Narratives (Ann Arbor: University of Michigan Press 2013) 239 pp. $33.95 Pb, $60 Hb. ISBN: 978-0-472-03635-6

In the early part of the twentieth century, breast cancer was a taboo subject, one which often induced hushed tones, superstition, or, most often, silence. In the 1970s, second wave feminism (combined with other medical and socio-cultural shifts) spurred changes in the way the Western world considers women's healthcare. Women advocated for transparency and agency in healthcare decision-making, and sought to change cultural perceptions of breast cancer bodies. By the 1980s, the Susan G Komen Foundation was established, and Audre Lorde had published her groundbreaking work, The Cancer Journals. In the late twentieth century, hundreds of essays, books, and creative works about breast cancer broke the silence and brought the discussion of breast cancer to the public. In the UK and the US, millions went toward breast cancer research, and pale pink became synonymous with hope for the fight against breast cancer.

In the twenty-first century, however, breast cancer writing seeks to complicate or interrogate established discourse around breast cancer, and bring to light fresh, complex, and previously unheard or unacknowledged perspectives, argues Mary DeShazer, in her 2013 book, Mammographies: The Cultural Discourses of Breast Cancer Narratives.  DeShazer, who authored Fractured Borders: Reading Women's Cancer Literature in 2005, incisively observes that breast cancer literature of the twenty-first century often challenges established biomedical practice, the corporatization of breast cancer through the pink campaigns, and survivor discourse, while highlighting oft-overlooked topics related to breast cancer, such as possible environmental causes, the 'ethics and efficacy of prophylactic mastectomy, and the shifting politics of reconstruction,' (1). De Shazer also notes that twenty-first-century breast cancer texts must also include queer discourse, and her text is one of a few which does so substantively and critically. DeShazer utilizes an informed interdisciplinary approach that relies on contemporary feminist theory of the material-discursive construction of the female body, and deftly integrates philosophical, literary and visual media theory to create 'a critical analysis of postmillenial autobiographical and photographic representations of this life-threatening illness' (1). The result is a text which does justice to the powerful and complicated legacy left by the experiences of women like Audre Lorde (and hundreds of others), but also offers the first and most comprehensive (to date) analysis of the features of contemporary breast cancer discourse.

The structure of this text is vital to its strength and effectiveness, and eminently useful to interested readers approaching the topic from either a scholarly or lay perspective. In each chapter, DeShazer puts forth a claim, and then offers a number of contemporary texts to substantiate her assessment, exploring them through interdisciplinary analysis and demonstrating the ways in which the texts are definitive of postmillenial breast cancer narratives. In the first chapter, 'Postmillenial Breast Cancer Photo-Narratives: Technologized Terrain', DeShazer combines theory on illness, embodiment, and autobiography from noted scholars like Sidonie Smith, Julia Watson, Einat Avrahami, and Thomas Couser to render her specific stance on photo-narratives. She claims they are a significant postmillenial method by which breast cancer storytellers can explore questions of narrative subjectivity, resistance, witness, and embodiment: 'The identity that the narrator of a breast cancer photo-narrative constructs engages a speaking or visually rendered "self" at once discursive and provisional [...]The lived experience that an autobiographer seeks to describe initiates a process of identity formation [...] giv[ing] rise to various forms of narrative and somatic subjectivity' (18).  In the remainder of the chapter, DeShazer analyzes Catherine Lord's The Summer of Her Baldness (a 2004 photographic memoir) and Lynn Kohlman's Lynn Front to Back (a 2005 photo-narrative), demonstrating ways in which Lord's is transgressive and transgendered, and the ways in  which Kohlman's presents contingent embodiment. Each chapter follows a similar robust and reliable structure; while presenting its point comprehensively and completely on its own, it also offers readers a springboard into their own reading of the many texts which DeShazer encourages them to explore.

The second chapter, 'Audre Lorde's Successors: Breast Cancer Narratives as Feminist Theory,' is likely to be of particular interest to readers, because it explores the ways in which contemporary breast cancer narratives resist hegemonic constructions of the female breast cancer body, a task which Lorde began over thirty years ago. Here, DeShazer opens from Diane Herndl's criticism that many late-twentieth-century breast cancer narratives failed to challenge social and medical norms, essentially remaining apolitical. DeShazer challenges this notion by analyzing three contemporary texts which, she claims, qualify the authors as Audre Lorde's political successors: Manmade Breast Cancers, by Zillah Eisenstein (2001); The Wounded Breast: Intimate Journey's Through Cancer (2001), by Evelyne Accad; and a trilogy of essays by S Lochlann Jain (2007-2010). These writers, according to DeShazer, 'affirm yet extend Lorde's vision' in a number of ways: they seek to break silences, identify and discuss alternative causes of breast cancer, challenge the medical establishment, question hegemonic constructions of femininity, queer breast cancer, and represent 'antiracist and transnational perspectives' (42). The chapter is significant because it gives readers a trajectory which connects the  past, present, and future of breast cancer discourse, offering opportunities for further exploration, discussion, and silence-breaking.

In subsequent chapters, DeShazer explores the ethics and utility of the latest preventative treatment for breast cancer, prophylactic mastectomy. She observes the importance of transgressive, rebellious (often irreverent) dark humour, in the context of breast cancer narratives, and approaches ethical questions around public witness and commemoration in autothanatographies, like the one by Susan Sontag, and the accompanying death photography by her partner, Annie Leibowitz. In the final chapter, DeShazer discusses the ways in which readers and viewers can engage with breast cancer autothanatographies in ways that are 'mutually respectful, perhaps even mutually constitutive,' (176). Here, she briefly cites theories on from Arthur Kleinman, Arthur Frank, and Susanna Egan about the relationship between suffering and witness, but readers may find themselves craving a bit more depth in DeShazer's discussions of the nature of witness and its specific importance in reflecting the writer's subjective position, affirming narrative identity, and altering intersubjective relationships and spaces. Nevertheless, DeShazer's text is a definitive work in studies and analysis of breast cancer narratives, and should not be overlooked by any reader wishing to involve themselves in important ongoing discourse about women's health.

Jessica C Hume, University of Louisville