One In Ten

Film by Nick Knight

Introduction

Nick Knight on the origin of 'One in Ten'

by Alice Rawsthorn .

I wanted to photograph women who've had single mastectomies, double mastectomies or reconstructive surgery by showing them as being strong and sexy. So I decided that the pictures should have some kind of sexual connotation, to be titillating, if that's the word.

'I've addressed issues like size and age in fashion photography, and for some time I'd thought I should add breast cancer. The fact that Charlotte (Knight's wife) had a breast cancer scare 18 months ago jolted me into doing something about it. One in ten women, or so I'm told, have breast cancer at some time in their lives. When I had to confront it with Charlotte, it seemed so negative, so overwhelming, because you always think: "It'll happen to someone else."'

'I wanted to photograph women who've had single mastectomies, double mastectomies or reconstructive surgery by showing them as being strong and sexy. So I decided that the pictures should have some kind of sexual connotation, to be titillating, if that's the word. Katy (England, the stylist on the shoot) showed me a book of portraits by Irina Ionesco. They're very sexual and, in fashion terms, right for the moment. If we'd been doing a fashion story, we'd have wanted to shoot it like that. We just happened to be doing a breast cancer fashion story.'

'We used all the tricks to make the women look sexy. Darkness, mystery, laces and veils, so you're always looking through something. The breasts are secondary, you don't notice them immediately. In the pictures of Nikki Umbertti, you can just see a glint of her nipple, which is actually fairly amazing, because it's tattooed onto her breast. I wanted the images to be unsettling so I thought of using props which were politically incorrect. I asked some of the women to hold a knife. Looking at Miranda Vicente with a knife, I had to ask myself whether my response would have been different if she hadn't had breast surgery.'

'There are twenty prints of each women going from darkness to light, and more than one portrait of each one, so you have a sense of the women emerging. I want people to look at the first portrait and see the woman in a very sexual way. But with the second portrait, she should turn the tables on them by making them feel, not like the voyeur, the one who's looking, but the one who's being looked at.'

Alice Rawsthorn is the architecture critic of the Financial Times and former editorial director of SHOWstudio.com

Interview: Nikki Umbertti

by Alice Rawsthorn .

When you find out you’ve got cancer, you just think: "Get it out." You don’t really care about what you’re going to look like.

‘I was misdiagnosed. I was 27 and modelling, I’d found lumps in my breast, but because I was so young, they assumed it wasn’t cancer. They said my lumps were cystic lumps from caffeine. But my gynaecologist was convinced there was something wrong. So I went back to my doctor and was sent to see a radiologist who misdiagnosed me. I could feel more lumps, so I went to another radiologist. By the end, I had ten tumours. Luckily, they all stayed in my breast. Otherwise I’d be dead. I had to have a mastectomy. By then, I was 29.’

‘When you find out you’ve got cancer, you just think: "Get it out." You don’t really care about what you’re going to look like. All I cared about was whether I was going to die, and that the cancer wasn’t going to spread to my brain. I cared about that. That was my goal, to get myself through it.’
 
‘It’s important for people to see that life doesn’t end with something like this, that life goes on, that you’re no less of a woman than you were before it. Breast cancer is so common now, and breast reconstruction is so common. It’s not taboo like it was before. I have very supportive people around me – my family and friends – who’ve been incredibly positive about it. The only hurtful or embarrassing remarks have come from older people, who’ve said them out of ignorance, because they’re uncomfortable with what’s happened to me.’

‘I’m conscious of how incredibly lucky I’ve been to have got through this, without the tumours spreading, especially to my brain. That’s a big fear.’

Nikki Umbertti is now studying dance and acting, but still models occasionally. She has made a short feature film, which was screened at the Woodstock Film Festival.

Interview: Miranda Vicente

by Alice Rawsthorn .

I have learnt to accept how I look. I get undressed now and it’s not a shock. I see myself and I think: "Okay, it’s not brilliant, but it’s not bad."

‘I found a lump in my right breast while I was in my early 20s and pregnant with my son, my second child. The lump kept growing during the pregnancy. I gave birth to him. They did some tests in Spain, where I was living, but they came back negative. It was only when I came back to England that they found I had a very invasive type of cancer you usually find in old people. I had to have a radical mastectomy, chemotherapy and radiotherapy. If they’d caught it earlier, the treatment wouldn’t have been a lot different. Maybe there’d have been less chemo’, but the tumour was really large. I asked about reconstructive surgery but, because the cancer was so invasive, they said I had to wait five years in case it came back.’

‘A year and a half later, it came back on the other side, a different type of cancer. Again, I had to have a radical mastectomy. They had thought the first cancer might come back as secondaries, but they didn’t think it would come back in the other breast. Although it did, it wasn’t connected to the first cancer.’

‘At the time, there wasn’t anything to suggest that I’d be a high risk. It was only subsequently that I was genetically tested and I was found to have a cancer gene that seems to skip a couple of generations in families. Looking back through the family history it seemed to have come out in me. Neither of my parents or any of my grandparents had cancer, but there were a couple of aunts. Once we traced it back, the link was too clear.’

‘Since then, everything’s been fine. The only problem is that because I’m carrying this gene, I have a very, very high risk of developing ovarian cancer, so I had to have my ovaries out. That eradicates ovarian cancer. There are other risks like bowel cancer but they’re much lower risk. Luckily, I’d already had two kids. I got them in quickly!’

‘I started reconstructive surgery in 1997. It’s quite a long process, but we’re nearly there now. I had reconstructive surgery on both sides. They remove muscle and skin grafts from your back to make part of the breasts and put implants underneath. I’ve had a few problems: muscle moving out of place and a slight problem on one side. That’s quite common. It’s very radical surgery and it takes quite a long time to get back to normal, especially as I’m having both sides done. The risk of infection and complications is quite high. It probably takes three months to feel better after surgery and for the physio’ to get things working again. But after so many years of surgery and therapy, each one takes its toll.’
 
‘I’ve had about ten major operations. It has been horrendous. The good part was that having the children kept me going, and the practicalities of life. Flying backwards and forwards every two weeks from Spain to have therapy in England. You just get on with it. Later on, it really hits you, emotionally and physically. When you’re going through it you cope, because you have to, but later on when things have levelled out, it hits you. I’m still feeling the effects now. I’m not as strong physically as I used to be, I get tired easily and my body can’t function as well as it used to, but that’s something I have to accept.’

‘The professor I was seeing sowed the seed in my head about reconstruction. He said: "I think you’re ready to have it done." It was pure vanity really. I wanted to be put back to how I was, but I felt it was a hell of a weakness. Why go through all that surgery to go through more surgery you don’t really need? It seemed such a silly thing to need to have my breasts put back on to feel whole again. I didn’t need my breasts for any reason, they weren’t going to aid me in my daily life. But emotionally, and the way I feel about myself, I feel much better now. When I get dressed and undressed it helps me a lot. Looking back it wasn’t just vanity.’

‘Before the reconstruction, I found it very hard. Living in Spain, it was very hot, so I was wearing little tops, and it was very obvious what had happened to me. Once I went to the beach. I had a bikini on but, obviously, I didn’t have anything to put in the bikini. There was a group of young boys and girls in their late teens or early 20s. They started pointing and laughing at me. It was horrible. I should have laughed it off, but I couldn’t. Unfortunately, anything different, people always look at it.’

Miranda also had concerns about reconstructive surgery. ‘I was worried that once I’d had the breasts put back on I might hate it more than before. I even said that to the surgeon: "If I really hate it, will you take them off again?" I needed to know that I could do that. I was really worried that I’d hate them, look awful and feel really bad.’

‘The result is amazing really. You’d never know. And I think that as time goes on and the scars fade, it will look even better. I think it gave me back a certain amount of confidence in my femininity and sexuality, which I’d lost. I felt that I didn’t have a right to feel sexual because I didn’t have all the right equipment. I knew that if I didn’t have it done I would regret it. I was so young, and I thought: "Have it done now, because you never know what tomorrow will bring."’
 
‘It has taken me a long time to get to the stage where I feel semi-okay with myself. I am getting there. I did like my breasts before. They were a very nice shape, a very nice size. They were pretty, I knew they wouldn’t look like that again. I knew they’d look very round and lumpy. It was very frightening. When I was going to the theatre on the trolley, I thought: "What am I doing? What if I’m making a real mistake?" But they’ve made me a bigger size, which is good, and I have learnt to accept how I look. I get undressed now and it’s not a shock. I see myself and I think: "Okay, it’s not brilliant, but it’s not bad." I put a bra on and it looks okay. It’s the mental thing. At first I felt like they (the reconstructed breasts) didn’t belong to me. Anyone who came round I’d show them, and say: "Have a look." It was like: they’re not mine so don’t associate them with me. But after a while they felt like they belonged to me. They were mine and I had to treat them with a bit more respect.’

‘My kids have seen me with one mastectomy, two mastectomies, and when I lost my hair with chemo’. I had these nipples made and they failed. They went into my breasts and disappeared. And my kids were like: "Where are they, mummy? Where have they gone?" They were so matter-of-fact about it. They’ve never had a problem with it and they’re not frightened of it.’

A former air stewardess, Miranda Vicente now does voluntary work for various cancer charities and is hoping to write a book. She has contributed to numerous press articles on breast cancer, and made a documentary on the subject for Channel 4.

Interview: Liz Bellamy

by Alice Rawsthorn .

The doctor asked if I wanted to consider breast reconstruction and I considered it for about 15 seconds. I didn’t want it. I’m perfectly happy with my body as it is.

‘I noticed that my left breast felt strange, really hard, as if I’d been breast-feeding. I went to see my doctor who said there was probably nothing wrong with me, but I refused to accept that. He said, "Well if it would make you feel more comfortable, I’ll refer you to a specialist." Two weeks later I was on the operating table. I had a very, very aggressive tumour that had already spread underneath my arm. So I had to have the entire breast removed.’

‘The doctor asked if I wanted to consider breast reconstruction and I considered it for about 15 seconds. I didn’t want it. I’m perfectly happy with my body as it is. I think if I’d had a leg removed it would have upset me more, but the only time anyone ever commented on my breasts was to say that I hadn’t got any. It doesn’t make any difference at all.

Also, I really love riding, and if I’d had reconstructive surgery, I wouldn’t have been able to go on my horse for a time, and I’d have hated that. I feel fine as I am now. Everyone we know knows that this has happened to me, and they’re fine about it, so why risk the surgery?’

‘The only time I’ve felt uncomfortable about my breast was when we went on holiday to Cyprus and saw all these young girls in skimpy bikinis on the beach. I’d had to buy this frumpy mastectomy bikini and, to make things worse, another woman was wearing an identical one. She was this huge German woman who must have been a size 20. I turned to my daughter and said: "Don’t say a word." Then I threw the bikini away. The only the thing that would worry me is how my daughter feels. She’s seven years old, and I’d never do anything to embarrass her like wearing a skimpy top or going into a communal changing room and making her realise that I’m different from the other mummies.’

‘There was no logical reason for me to have cancer. There’s no family history. It has changed me. I used to be the type of person who didn’t feel happy unless she was worrying about something, and that’s changed. I’m calmer and more contented. I think I’m a nicer person to live with, at least my husband says so.’

‘Why am I doing this shoot? I’ll do anything I can to make people more aware of the risks of having breast cancer.’

Interview: Anne Stansell

by Alice Rawsthorn .

You are you, do not be influenced by social pressures to change your appearance by surgery; it is not the answer. We are beautiful, strong, vital women just the way we are.

‘Fourteen years ago, at the age of 39, I had a breast infection. For several years I’d had a lump in my left breast as a result of a minor injury in an airplane accident. The surgeon said: "If you’ve had this lump for several years and your regular doctor has been following you, it is probably alright." My husband asked her: "If this was your breast  what would you do?" Her answer: "I’d have a biopsy." The surgical biopsy showed intraductal cancer. ‘The following week I had a radical mastectomy. Nineteen lymph nodes were removed and tested, none were cancerous. And there has been no recurrence.’

‘Three specialists told me: "You have breast cancer, you need a mastectomy, radiation therapy and breast reconstruction." As if it was all part of the treatment. I felt as if the doctors had just saved my life, I trusted them. At first I liked the breast implants. It helped me be in denial about having had breast cancer.  People could not tell I’d had my breasts amputated, and I did not mention it, either. The breast cancer rate continued to escalate and I found that if no one spoke up, people were very comfortable not seeing anyone who may have survived this dreaded disease.’
 
‘After a few years the breast implants became very painful, one had shrunk to half its size, and I realized these lumps  did not resemble breasts at all. Then I became ill with many strange symptoms. I did not realize that my dry eyes were caused by the leaking breast implants. My retina tore in my eye it was so dry. My memory was impaired, as was my vision. I had chronic fatigue, I had skin disorders, the list goes on.’

‘I had the implants removed and now my chest is so tender I cannot wear any prosthesis at all. I can only wear soft clothing like knit shirts. But my health is improving. My symptoms are subsiding, although I have a way to go before I will feel myself again. My confidence is in the fact that I have survived cancer, and have survived breast implants.’

When the specialists were advising Anne to have reconstructive surgery: ‘There was no discussion that silicone breast implants were not and never had been approved by the FDA. I was not told that there had been no research on mastectomy women and breast implants. I was not told that breast implants block mammography. The recurrence  of breast cancer was my number one concern, not how I looked in a bathing suit. I was not told that breast implants caused many illnesses.’

‘I was told that breast implants would last a lifetime. Now I’ve learned that the rupture rate is unacceptable. After 10 years, 50% of all implants begin to fall apart and leak; and at 20 years nearly all implants have ruptured. This is true of all implants no matter what their filling (silicone, saline, soy oils, etc) as all implants are encased in a silicone envelope. These statistics are from the FDA.’

‘I decided to participate in the shoot with Nick Knight as it has been my mission to encourage all women, whether affected by breast cancer or not, to be accepting of their bodies. Whether breasts are small or large, they are yours. You are you, do not be influenced by social pressures to change your appearance by surgery; it is not the answer. We are beautiful, strong, vital women just the way we are.’

‘Furthermore, I encourage women all over the world that if they are diagnosed with breast cancer, they too, can be survivors. I encourage women who have had mastectomies to remain the same women they were; to capitalise on the strength and courage gained during their illness and be proud of the fact that they are survivors.’

Anne is now a photographer, who dedicates her work to breast cancer survivorship. Her photographs of women and their stores, Silicone, the Sequel, is available for exhibit at universities, breast cancer charities and art galleries. For more information contact: AnneStansell@juno.com

Interview: Harriet Close

by Alice Rawsthorn .

I think you know when something’s wrong. It’s like the mother’s instinct of knowing there’s something wrong with your baby. I just knew.

‘I discovered it myself, a small lump in my breast. It was in January, well, to be honest, it was just before Christmas, but I decided to have a happy millennium and waited until the first available day in January to call up for an appointment. I was very lucky because it was very noticeable, I’m afraid I wasn’t one of those people who check regularly. It felt like a little pea. I rang up my girlfriend who happened to be gynaecological surgeon and she recommended that I go and see a specialist. Luckily, I have medical insurance, and I saw him within three days.’

‘The specialist said he didn’t think it was anything particularly sinister. He took samples with a needle which was, I have to say, the most excruciating part of the whole thing, worse than having a baby. About four days after I saw him, I had a mammogram. Nothing showed up on the mammogram, but I had an ultrasound immediately afterwards and it showed up there. The doctor who was taking the ultrasound felt it was cancerous. Then I went back to see the specialist and, sadly, he confirmed it.’

‘That was on the Friday and on the following Monday I was in for a day’s surgery. I had the lump removed. I was in the morning and out in the afternoon – no ill effects at all. I was very, very lucky. Then I had to wait and go in the following week to have more tissue taken out, and all my lymph nodes taken out as well. And I had to wait for the results of that. There were two nodes they were slightly worried about. I discovered later that they were slightly infected by something I’d probably got from a cat scratch. That whole process took about a month. They let me rest for a while, then I had six weeks of daily radiotherapy every day. I didn’t have to have chemotherapy. I was lucky. From start to finish from the January check-up, I was finished with radiotherapy by the end of March. I have since gone back for a three-month check-up. So far so good.’

‘I was very scared, but I wouldn’t show anybody. I’m a single mum, I have a 15-year-old son, and I didn’t want to frighten him. But I was honest with him about everything I was going through. I told him I had cancer and about the treatments.’

‘The cancer came without any warning at all. I’m adopted so I have no medical history. They felt that my breast cancer was probably very much hormone-related. But I have no idea, because I don’t have any history. It’s strange, but as soon as I found the lump, I thought it was going to be cancerous. I think you know when something’s wrong. It’s like the mother’s instinct of knowing there’s something wrong with your baby. I just knew I had to have the lump checked out. I wasn’t scared though until they actually told me. I just thought: "I think this is going to go wrong. I think this won’t be a happy outcome." Having said that, I’ve been very lucky because I caught it terribly, terribly early.’

‘Because I haven’t had a huge amount of breast tissue taken away there’s not a dramatic difference in the way my breasts look. At the moment because it’s still quite recent, my left breast is quite swollen with the scar tissue and everything, In fact, that breast is looking better than the other one. Time will tell.’

‘I was going out with somebody at the time (the cancer was detected) and I was very scared about showing him what I was going to look like. I wasn’t sure how he’d react, and I was scared of that. Probably he was scared of the whole idea, I had to stop going out with him. But I have found that it has enriched my life. It made me realise who my real friends are. Nobody reacted negatively. There were people I hadn’t seen for ages and had lost touch with, who heard about it and came to see me in hospital. "I had to come and see you." That sort of thing. It made me feel: "Right you’ve got to evaluate your life. You’ve got to see what’s important." In the scheme of things, so many things are unimportant, but we get so wound up by them. Stress can be so much part of getting cancer. I’m much more relaxed these days. I used to be the sort of person who’d get worried about stupid things. So it has been quite cathartic.’

‘After the surgery, almost as soon as I could, I was on the phone to them saying: "How can I help? How can I do something?" I just wanted to help one way or another. It’s not such a terrifying thing – cancer – these days, but it still instills fear in a lot of people. And I just wanted to show that you can still be there, positive about things and still attractive. Perhaps I shouldn’t say this, but I get a little fed up with these beautiful people with perfect breasts in Breakthrough advertising. I know they want to make people aware of breast cancer, but I think "Well what the hell are they doing it for?"’

Harriet Close, a former model, who now runs an agency for older models, has supported Breakthrough, the fashion industry’s campaign to raise awareness of breast cancer, for many years.

Interview: Sue Loosley

by Alice Rawsthorn .

The consultant did talk to me about reconstruction, but I didn’t want it. I’m quite happy as I am. It wouldn’t make any difference to the way I feel and I don’t want more scars.

‘It was about four years ago, I was sitting with my daughter one Saturday morning having a girlie chat, when I felt inside my arm and realised I had a lump. I went to see my GP in the next few days. He looked and said that I should get it checked out. A few days later I was told I had to have a lumpectomy.’

‘At the same time, my father was very ill, so I couldn’t talk to my parents about it. I’d just been in long term relationship, but that had come to an end. And I couldn’t talk to my kids about it. They’re twins, they were 15 then, and I’ve been a single parent really since the day they were born. I lied to them about how serious it was. I shouldn’t have done, but at the time I just tried to save them from hurt. I couldn’t deal with how upset they’d have been. When I eventually went into hospital for the lumpectomy, I did tell them. I said to the kids: "I told you a lie." I went into hospital for the operation the day before their 16th birthday.’

‘After the lumpectomy, I felt very confused. The man I was involved with at the time, who was a good friend, asked me to marry him. And because my esteem was so low I said "yes". I didn’t really want to. Then I came round and I knew I didn’t want to marry him. It was all called off. After that I didn’t have a relationship for about three years. I didn’t want one. I decided that I was going to do all the things I ever wanted to do. I haven’t done them, but it put the fight back in me.’

‘The consultant did talk to me about reconstruction, but I didn’t want it. I’m quite happy as I am. It wouldn’t make any difference to the way I feel and I don’t want more scars. I don’t want to have to go away again and re-heal after more surgery.’

When she found the lump in her breast, Sue had just finished a training course. She has since gone back to college to do a management course, and now does contract work. Sue has also become involved with cancer charities. ‘I do quite a bit locally – fund-raising and raising awareness, reminding people that it could happen to anyone. I always thought: "It’s never going to happen to me."’

After the lumpectomy, Sue had various treatments, including a course of radiotherapy. Later, it was discovered that that the radiotherapy had damaged her heart and she had to go back into hospital for more surgery. ‘I don’t know how serious the damage was, but I had to have a pacemaker fitted. I had that two months ago.’

‘I think my kids were okay with the cancer, but since the pacemaker my son has withdrawn from me. Until then he’d been very good, but I think it’s his way of coping with hurt and being frightened of losing me. It took him two years to get over the cancer, and then there was the pacemaker. I need to talk to him. We used to do that. I’d say: "Come on, let’s have a chat. Tell me what’s bothering you." I need to do that again. He feels he needs to be the man, but he’s panicking and feeling scared. My daughter is the other way. She is very affectionate with me. We spend a lot if time together and she’s always checking up. "Are you okay?" And if she goes out now, she’ll ring me to make sure that I’m okay.’

Interview: Matuschka

by Alice Rawsthorn .

I will continue to use my body as a statement because the more you see a woman with one breast, the more you accept it.

‘I found the tumour myself, the doctor said it wasn’t cancer. My mammogram didn’t show it. Three mammograms didn’t show it. Then went to the best professor in New York, and he said: "There’s nothing to worry about." But I said, "I want it out immediately. My mother had died of breast cancer, when she was 41, she was diagnosed when she was 39. And she was given the wrong information." The reason why I was going to these specialists was because of my mother’s death. There was no breast cancer awareness campaign at the time.’

Matuschka had a lumpectomy and the tumour was tested. The professor summoned her to tell her the result of the test. ‘He said: "It could be cancer." And he said if I didn’t get all the cancer out, I could be in a very bad condition. He recommended a mastectomy.’ Matuschka’s breast was removed. This was 1991.

‘Then I had to go to an oncologist, and they kept looking at the pathology report and saying: "Why did you have to have your breast removed for something like this?" Then, when I went also to find out if my lymph nodes had been involved, he said: "You have no cancer in your breast or your lymph nodes." So I said: "So why did my breast come off? I was under the impression that I’d had my breast removed because there was cancer."’
 
‘I sued him and won the case. I did an investigation, which took two years and included taping his conversations. You’re allowed to do that in New York. I just couldn’t believe he had made this mistake, but it turns out that the pathology report and his doctor’s notes were different. In the court case, they said it was a typographical error, that he had mis-transcribed his notes. I sued in 1993 or 1994, and it took five years to get to court.’

‘When I found out that he had erred, I went right into activism. I figured, here I was – white, middle class, college educated, best insurance policy, best doctor – and I had to suffer that. What was going to happen to all those people who don’t speak English, don’t have access to information and don’t have health insurance?’

‘If I had listened to my doctor at first when he said: "There’s nothing to worry about, you don’t need this out." If I had not taken the position that my mother was given the wrong information and said: "Hey! I want it (the lump) out tomorrow," I would have been in worse shape, obviously, but I would have still had a breast. I’d had all the surgery I needed in the first operation, the lumpectomy. There was no need to remove my breast.’

‘So, I figured, if this is happening to me, I need to go out and get more information. So I jumped on the bandwagon. I was part of the early breast cancer movement in early 1990s America. I protested and pasted my posters all over New York and Long Island, and I tried to get my photographs published.’

‘First, I took pictures of other women, but that didn’t work because everyone said: "Oh, the women don’t look attractive, they’re too angry." So, because I had been a model, I said: "Well, I’ll step in. I’ll take these self-portraits." I made them look very romantic and very beautiful. This, it seems, is the only way to get the message across. But I still could not get my pictures published anywhere in America, including Ms magazine and Mother Jones. And I was amazed because some magazines in Europe would publish my work, but not in America.’

‘I was fortunate enough to be at the first Breast Cancer conference in 1991 in Washington DC. I’d brought my posters. I’d made one called "Vote For Yourself", which was sponsored by a woman’s group. I was not allowed to display the poster or sell it, so I wore it. I put it on the front and back of my body like a sandwich. A correspondent from the New York Times saw me walking around with this poster on my front and back. It was a pretty striking image and she turned it into a story. The New York Times called me and asked me for my portfolio on breast cancer. The requirements were that (to be publishable) it must be in colour, vertical and can’t show any breast. And I said: "Well, I’ve got a picture!" I had a picture of me with a white dress cut away where the breast was. And that picture really helped launch the breast cancer movement. It’s still considered the Mona Lisa of breast cancer.’

‘I’m delighted to be involved in this shoot, because I think it’s a way to embrace women who have one breast or no breasts or breast cancer. Unfortunately, there is really no great remedy of rebuilding a breast. There are many women who end up having their implants removed or who can not have breast reconstruction. I have been vacillating about that (reconstruction) for years. But I’ve seen enough pictures of women who’ve had their breast implants removed and it looks much worse, to my eyes, than a mastectomy. And it’s more surgery. A muscle here, a muscle there. More scars, more pain, skin stretching, skin sagging.’

‘Summer is always a really hard time for me. There is such a big emphasis on breasts. So many women are getting implants and everyone has got these padded bras and push-up bras. Half these women don’t even need to wear a bra, but they want to make themselves look as though they have large breasts. So when I walk down the street in the summer I get these very, very strange looks. It isolates me and makes me relate to people differently, even though I’ve accepted myself.’

‘It’s difficult when I take my clothes off and walk into a locker room. And it’s difficult when men meet me, not necessarily because they can’t deal with the image, it’s that they might think I’m going to die because surgery usually indicates worst prognosis. If you think I’m diseased, if you think I’m unhealthy because I’ve only got one breast, you might not want to get involved with me in case I die of cancer.’

‘A man in a wheelchair, I happen to find it very sexy. If someone had one leg, I wouldn’t have a problem with that at all. Even if men have testicular cancer and have one testicle removed, it’s not the same as having a breast removed because a breast is way out there and it’s so much more transparent. That’s the thing about breast cancer it’s so external, like an arm or a leg. I will continue to use my body as a statement because the more you see a woman with one breast, the more you accept it. After all I’ve done, and I’ve been out there marching and campaigning for years, I’m still amazed at the way people look at me.’

‘I was in denial for many years about having a breast removed, because I was so into my art. I never dealt with the problem or mourned for my breast. I was right into how can I make this into art? What can I do to make a contribution? I was so involved in demonstrations and conferences and the making of the art, I didn’t get a chance to really deal with the fact that I will be like this for the rest of my life, that I will have to look at myself every day and there is no denying that I had breast cancer.’

‘I was constantly trying to turn it into a positive. And I don’t regret doing that because, number one, I helped save many womens’ breasts. I can quote five letters from women who have come to me and been told: "You don’t have to have your breast removed. You don’t have to have radiation, it’s your choice." They still have their breasts and they’re still alive. So I have helped them, and their husbands probably and, to a certain extent, I must have helped myself.’