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.

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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!


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

What do you want to know about your surgery?

What are the implications of losing a breast or both breasts? Will it be painful? How long will I take to recover? When I get back to my normal day to day activities? Will I have scars? These are the questions that follow once a patient knows that they will need a mastectomy. People respond to the news of needing a mastectomy in many various ways. Some people want it as soon as possible, others delay as they are not sure that it is the right thing to do or they may be anxious or nervous about it. Everyone is different.

What are the implications of losing a breast or both breasts?

When you research a mastectomy it is very easy to become anxious. Whether about the operation, recovery or what you will look like after the surgery. Many people, organisations, doctors and surgeons will write about the topic but unfortunately what you read is not always accurate and can cause mixed emotions. The best way to understand the process is to listen to your options from your surgeon and to meet and talk with a person that has been through a similar experience or had a similar operation.

Will it be painful?

Very often there is more emotional than physical pain after a mastectomy. It is something new that one has to get used to. It takes time and everyone will go through their own recovery at their own rate. You may be happy, sad, teary or relieved. A whole wave of emotions may follow after having a mastectomy.

How long will I take to recover?

This will depend on the person, the type of operation and the circumstances that surround the patient. It takes a good few weeks to recover from a breast operation but again the emotional side may take longer than the physical side. Getting back to day to day activities will gradually increase and become easier with time. It is important to take time to recover and to not do too much too soon. If you rest in the beginning your recovery tends to be quicker. If you are very busy straight after your surgery and do not give yourself time to recover, the patient will tend to have a lot more aches and pains that may continue for a lot longer than usual.

Will I have scars? The answer is yes. If you have an operation, you will have a scar. Scars however, do not have to be associated with something bad. There are ways to minimise scars and each surgeon will have their own way of looking after wounds and scars. The emotional scars on the other hand may remain for quite some time. As we are all different, we will all heal in different ways. It is very important to ask for help if you need it. Whether speaking to a fellow patient, a psychologist, your GP or your medical team, it is important to communicate. It is a natural feeling to be anxious regarding a pending operation and even after the operation it remains important to communicate. Therefore speak to someone before your operation and have that person as a support during your operation and after your operation as you recover. Recovering mentally is a process that starts from the time that you are diagnosed.

Most importantly, try to stay positive! Surround yourself with positive, happy and supportive people that make you feel good. Do not be afraid to ask for help when you need it! A little bit of support goes a long way when needed.

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


South Africa & Breast Cancer: Reality Bites

D I D    Y O U   K  N O W  ? 

  • 15 % of the population use Private Sector Health: they are served straight away upon diagnosis.
  • 85% of the population use Public Sector Health have to wait…


Basket of Services - Breast Cancer in South Africa

Women in Private Sector care have access to the entire ‘basket’ of services:

  1. Surgery
  2. All forms of treatment
  3. Supportive care
  4. Breast reconstructive surgery
  5. Breast prostheses
  6. Lymphoedema service

This is, however, not always the case for the Public Heath Sector.

Saying that, even women in the Private Sector can miss out on receiving full cover from their medical aids for their actual cancer diagnosis and all associated treatments if they don’t carefully inform themselves by making sure to read the FINE PRINT of their policies! If they don’t thoroughly know the conditions of their medical aid policy, they will end up joining the treatment queue with their sisters in the Public Health Sector.


If 85% of our women are in the public sector how many of them are lucky enough to get the full ‘basket of services‘?

Breast Cancer - Basket of Services

Once again, it is our responsibility to equip and empower ourselves – as well as our sisters – with the knowledge necessary to make sure we have our rights met!

My New Wardrobe


Any body change requires some wardrobe adjustments. But while shopping for maternity wear can be exciting, shopping for cancer wear is not fun for anyone.

Losing one’s hair and losing one’s breasts – these are the two major body adjustments most people associate with a breast cancer diagnosis. But you are not ‘most people’ and the intrinsically important thing to remember while contemplating one’s changing body and the related body image adjustments that will require, is that every individual needs to make the decisions most comfortable (and comforting) to her. The second most important thing is that, along with everything else on this cancer journey, circumstances and requirements will change along the way.

Immediately post-surgery there are some basic truths.

You will not be able to lift your arms over your head for a while, so front-fastening shirts with buttons or zips will be a must.

If you’re having a tissue flap reconstruction (procedures using tissue from your tummy, back, thighs, or buttocks to rebuild the breast), you will need clothing which is easy on the additional wound sites for the period of recovery too.

If you’ve had lymph glands removed your doctors will talk to you about the risks of lymphoedema (the accumulation of lymph fluid on the side of your body on which you had surgery which can lead to swelling and pain), and the use of compression sleeves and other garments. While extremely functional, these needn’t always be unattractive. American company LympheDivas (link below) specialises in ‘Medically Correct Fashion for Lymphedema’, and they ship to South Africa too.

During chemotherapy most (but not all) patients will lose their hair. It’s a good idea to have some thoughts before this happens on how you’re most likely to deal with that.

If you’ve chosen to invest in a wig the common advice is to: purchase one before chemo starts (while you still have the energy), choose the right colour to suit your skin tone (style can be changed by a practised hairdresser), purchase it in person (there are lots of online sources but you really need to try a wig on) and don’t forget the accessories (care products, a stand, wig caps for wearing underneath it).

Many women chose to wear hats and headscarves instead, but some patients say it’s nice to have a wig for special or specific occasions (I know someone who only ever wears hers to school functions, to make her children more comfortable). And don’t forget a head without hair can get chilly – invest in some soft cotton sleeping caps.

And the big one: if you’ve chosen not to have reconstruction at this time – then you might be shopping for prosthesis. Visit BreastFree to read up on the many prosthetic options, as well as advice on not using prosthetics at all. Locally the Like B4 Mastectomy Boutique provides a dedicated fitting service for underwear and swimwear and with trained consultants to find the best fit, for you.

Recommended Links:

LympheDiva’s (patterned compression garments)

Compassion Hat (local head scarf manufacturers)

A good list of Western Cape based wig providers here:


Like B4

Recommended Read: (packed full of links to post-surgery clothing providers, all international but many sell online or have local suppliers)

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