Tracey Derrick - photographer - breast cancer survivor - mastectomy - tattoo


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Tracey Derrick - plaster cast of her chest post-mastectomy - self portraiture: photography

Today’s photograph from Tracey Derrick‘s body of work, 1 in 9, is a photograph of the plaster cast she made of her chest, post-mastectomy. Through the tender replication of her chest, she somehow manages to both powerfully AND gently obliterate the media’s ‘requirement’ for women to ‘build themselves back together’ into a state of ‘normal femininity’ —- and instead presents us with a portrait of herself simply as she is: pure, unencumbered, real and unutterably and beautifully herself: unique!

Whether we choose reconstruction, to wear breast prostheses or go breast-free, the power of choice lies in our hands: it is our choice, and our choice alone.

If you would like to share your story about your post-mastectomy body
and your new, YOUnique normal,
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ART THERAPY BLOG: Activites & Ideas


  • We love the idea of art journalling as creative ‘self therapy‘ (click here to read more!) but the website is full of other wonderful  ideas – and we recommend signing up for her very helpful and inspiring newsletters too!


Breasts: Object, Device, Possession?


“After breast cancer treatment this identity of ‘desirable object’ becomes confused because the ‘traditional’ nude, as an idealized object of male desire, clearly precludes any possibility of illness or ‘imperfection’ and denies the ‘unacceptable’ hidden truths within, for example, the scars, a single breast, lumpy breasts, false breasts; changes that women live with after treatment. Through the media, the ideal woman is ‘put together’ and defined by appearance.

Artist Jo Spence was especially concerned with the breast as an object of desire, as a device for nourishing babies, and finally in her case of breast cancer, as a possession to be placed in the hands of the medical institution. This is exemplified by her photo of her breast, marked with a pen “Property of Jo Spence?” where she appears to question her rights over her own body, using the breast as a metaphor for women’s struggle to become active subjects. Following her *lumpectomy, she documented the appearance of her scarred breast, thereby challenging traditional representations of that subject. In one image she documents the struggle between her everyday appearance (revealing her scars), and the glamorous representation of women – signified by the Hollywood-style sunglasses and the seductive pose and drape of her blouse off her shoulder. (1986:157)

*Lumpectomy is surgery in which only the tumor and some surrounding tissue is removed. It is a form of “breast-preservation” and technically is a partial mastectomy. Jo Spence had a mastectomy later on in her life when her breast cancer returned.” ~ Tracey Derrick



This Simple Act Helped Me…

Tracey Derrick - breast cancer portraiture - mastectomy surgery - Dr Paul Whitehead

“Myself as Subject

Documenting myself began during my mastectomy operation. It was the first time that I had ever had surgery and requested the surgeon and nurses to take photographs of my operation.

Afterwards in hospital I had a borrowed digital SLR camera with me. This simple act of holding a camera helped me feel more secure and that possibly I had some control over the situation.

This was the beginning of participating in my own recovery from cancer and the first time that I had ever used a digital camera.” ~ Tracey Derrick


TAKEAWAY: Amelia’s Story

Reconstruction after mastectomy

There are various types of reconstructions that can be offered to a patient after a mastectomy. There are many factors that need to be considered before one can decide on a reconstruction and this needs to be discussed between the patient and the surgeon. Each person is different and the type of reconstruction is based on many various factors including:

  1. The choice of the patient as discussed with the surgeon and multidisciplinary team
  2. The type of cancer
  3. The location of the cancer
  4. The build of the patient
  5. Involvement of the nipple
  6. Whether the patient will still need radiotherapy or not


There are many types of reconstruction, most of which are available in South Africa. Reconstruction can be done as an immediate reconstruction or a delayed reconstruction.

  1. A flat chest: many people will request a flat chest. Women will often choose this procedure as it is a fairly quick operation with minimal pain post operatively and has a low risk of complications. A prosthesis with a special mastectomy bra can be fitted a few months after the operation. The patient can also have a reconstruction a few years after having a flat chest mastectomy, this is known as a delayed reconstruction.
  2. A reconstruction using expanders: this is where an expander is placed beneath the muscle in the chest wall. It is then inflated every few weeks until it reaches the appropriate size. An operation to remove the expander and replace it with a prosthesis will follow.
  3. An immediate reconstruction using prosthesis: this is done in certain cases where a skin sparing mastectomy is performed and the tissue is immediately replaced with a prosthesis.
  4. Reconstruction using body tissue:
  5. A flap from your back (latissimus dorsi flap) – the surgeon will make a new breast by using the muscle, skin and fat from your back.
  6. A flap from your abdomen (a TRAM flap) – the surgeon uses part of the muscle with its skin, fat and blood vessels to make a new breast.
  7. A flap from your abdomen (a DIEP flap) – the surgeon takes only the fat and skin from the abdomen to make a new breast. This procedure often has a very good outcome as the breast looks and feels natural as it consists of fatty tissue.
  8. A flap from the thigh (TMG or TUG) – the surgeon will use the fat, skin and muscle from the thigh, either making use of the outer or inner thigh.

Once a mastectomy with reconstruction has been performed, a nipple can also be made. This would be done only once the reconstruction has entirely healed and would involve small procedures. A tattoo can be done to give the nipple areolar its colour.

Reconstruction is a very personal decision and the patient should not be rushed into something that they do not feel comfortable with having. It is important as a patient to look into the various options that are offered before making a decision.


Sr Lieske Wegelin

ABC - Advocates for Breast Cancer - Breast Course 4 Nurses

Biopsy Basics: Luminal A & Luminal B

In looking at the Luminal A and Luminal B breast cancer sub-types, we’ve summarised excerpts from a variety of expert sources into which we’ve included links for you to follow for deeper insights.

advocates for breast cancer_biopsy_luminal a and b
{ original cellular images courtesy of }



Luminal A and Luminal B types:

  • The luminal types are estrogen receptor (ER)–positive.
  • The gene expression patterns of these cancers are similar to normal cells that line the breast ducts and glands (the inside of a duct or gland is called its lumen).
  • Luminal A cancers are low grade, tend to grow fairly slowly, and have the best prognosis.
  • Luminal B cancers generally grow somewhat faster than luminal A cancers and their outlook is not as good.

READ MORE:American Cancer Society‘s Detailed Guide to Breast Cancer Classifying 



Luminal A — the least aggressive and most common subtype — accounts for 42% to 59% of all breast cancers, according to background information in the study.

Luminal B typically occurs in younger women and accounts for about 10% of all breast cancers.

Current research suggests that luminal A and luminal B cancers are two completely different diseases, and work is being performed to better distinguish between these two disease types so as to deliver more effective therapy to individual patients.

(Quite medically technical article!) READ MORE:→ The Oncologist‘s New Developments in Hormone Receptor–Positive Disease


Luminal A:

  • These cancers grow slowly.
  • When cancers turn up on screening mammograms, they are most often Luminal A.
  • They have a cure rate of more than 90% and generally can be treated with limited surgery and radiation.
  • Chemotherapy is usually not necessary.

Luminal B:

  • Compared to Luminal A, these cancers are more likely to grow aggressively
  • Can spread into blood vessels and the lymph system.
  • Not as aggressive as Basal and HER2-positive cancers.
  • Luminal B cancers can be challenging to remove completely, so a second surgery is sometimes necessary to achieve clear surgical margins around the tumor with no cancer cells.

READ MORE: Know Your Breast Cancer‘s How Genomic Tests for ‘Subtypes’ Help Target Treatment


Luminal A

  • Luminal A breast cancer cells can remain in a single location without spreading into the lymph system or blood stream.
  • Because Luminal A breast cancers are so slow-growing and unlikely to spread, there is a risk of overtreatment.
  • Luminal A breast cancers can generally be cured without chemotherapy, using limited surgery alone or in combination with radiation therapy.
  • Left untreated, there is a possibility that Luminal A cancers can develop into Luminal B cancers.

Luminal B

  • Unlike Luminal A cancers, which are situated in a specific site, Luminal B cancers can manifest in multiple sites within a particular region of the breast, with normal breast tissue existing in between.
  • In these instances, mammography often underestimates the size of primary cancers and fails to detect secondary cancers.
  • Magnetic resonance imaging (MRI) can help to more accurately measure and detect Luminal B cancers.
  • Treatments for Luminal B breast cancers can include limited surgery, mastectomy, radiation therapy and chemotherapy.
  • Recommended treatment options available to each woman will vary based on a range of personal factors regarding her disease and her risk factors.

READ MORE: Breastlink‘s Types of Breast Cancer



ARTICLE: Understanding Your Pathology Report


VIDEO: Understanding Pathology for Breast Cancer


PHOTOVOICE: Braving The Storm

“I chose this photo because it shows my breast that isn’t there any more. This is my scare, but also my reminders that I conquered cancer.”

~ Margaret, 73 years old (Bonteheuwel, Cape Town)

poor quality follow up2



poor quality follow up poor quality follow up1


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