Cankerous Femme: The European Mastectomy and the Semiotics of Surgery

Abstract

Over the course of the ‘long Enlightenment’, surgical intervention became one of the leading treatments for cancer. In their various writings promoting surgery’s efficacy over internal remedies and unguents, surgeons employed one image more than any other: a woman with two needles threaded through her left breast. The method this illustration describes was known colloquially at the time as the “twice-a-cross”. The function of this image, however, did not remain constant. At first created as a warning against employing this specific technique for breast cancers, in other contexts, the figure promoted the twice-a-cross as the standard procedure for all breast amputations. From its first printing in 1655 to its final iterations in the 1750s, the image served various roles —technical diagram, promotional aid, and sign of endorsement— before it returned to its original function as a condemnation of surgery’s barbaric past.

Yet, what appears at first to be a denotative representation is, in fact, a historically contingent construction, dependent on genre conventions and broader debates about progress, tradition, and the status of surgery. By tracing the migration and transformation of this image of the twice-a-cross procedure across different publications, cultures, and even ontologies, this dissertation demonstrates how the copying of extant figures held an important role in early modern medicine. Using the mastectomy as a case study, this study reframes mimetic figures not as straightforward visualizations of real-world referents, but as sites where knowledge, history, and professional legitimacy were actively negotiated and renegotiated. These ‘sites’ had real-world implications on patient treatment and care.