Bathsheba's Breast: Women, Cancer, and History (review)

Only recently have historians begun to address the history of breast and other cancers. Bathsheba's Breast is one of the latest additions to this growing historiography. James S. Olson, a professor of history at Sam Houston State University and himself a cancer survivor, tells the story of breast cancer from antiquity to the present, often focusing on notable women with the disease. These range from Anne of Austria, the mother of Louis XIV of France, who noticed a lump in her breast in 1663, to Jerri Nielsen, the physician who diagnosed herself with cancer in 1999 while on a scientific mission at the South Pole. The Bathsheba in the book's title is Rembrandt's mistress, Hendrickje Stoffels, whose probable breast cancer may be visible in the famous 1654 Rembrandt painting, Bathsheba at Her Bath.

Among the major figures in Olson's story, not surprisingly, is William Halsted, the Johns Hopkins University professor of surgery who revolutionized the treatment of breast cancer in the late nineteenth century. Rejecting the centuries-old theory that breast cancer was a systemic disease, Halsted argued for aggressive local treatment with an operation known as the radical mastectomy. While perhaps appropriate for the large cancers of the Halsted era, in which women often concealed their lumps for years, Halsted's disfiguring procedure and its more radical variants were nevertheless overused in subsequent decades.

Olson describes other champions of radical breast surgery, such as Memorial Sloan-Kettering Cancer Center's Jerome Urban, as well as the iconoclastic physicians who came to challenge Halsted. Foremost among these was George Crile, Jr., a surgeon at the Cleveland Clinic. Olson also describes subsequent developments in the history of breast cancer diagnosis and treatment: the push for early detection through breast self-examination and mammography; the rise of radiotherapy and chemotherapy; the debates over estrogen use; and the emergence of a powerful breast cancer advocacy movement.

The author spends considerable time discussing a series of women who developed breast cancer in the 1970s and then went public with their diagnoses. Shirley Temple Black, Betty Ford, and Happy Rockefeller, he argues, helped to eliminate the forced silence that had for so long characterized responses to the disease. Another prominent woman in Olson's story is Rose Kushner, a Maryland journalist who challenged both the radical mastectomy and the authority of the medical profession after being diagnosed with breast cancer in 1974.

Bathsheba's Breast does resurrect a few forgotten stories from the history of breast cancer. These include an interesting and chilling account of Adolf Hitler's compassionate concern for his stricken mother, Klara; he later allowed his mother's devoted physician, a Jew, to safely leave Nazi Germany. A chapter on alternative cancer therapies, although not really about breast cancer, provides a useful summary of questionable medical and psychological remedies that desperate patients have pursued. Throughout the book, Olson is careful to place medical developments in their social and cultural context.

However, there is not much information in Bathsheba's Breast that is not already available in other historical accounts of cancer. In addition, Olson has used only published materials, and he takes accounts from the New York Times, other newspapers, magazines, and biographies at face value. Most disappointing is his decision not to address several recent books and articles on social and historical aspects of breast cancer.¹ As a result, he never discusses how his findings either concur with or differ from those of other authors. For example, although Olson examines environmental activist Rachel Carson's fight with breast cancer, he does not mention Ellen Leopold's A Darker Ribbon (1999), which included an in-depth analysis of Carson's interaction with her physician, George Crile.

On a more mundane basis, this book contains a number of small errors. The Scottish physician...