http://oncology.thelancet.com Vol 8 July 2007 583 Media Watch Exhibition Breast cancer: an artistic view Medicine and art have long had a close connection. In fact, the practice of medicine in previous centuries was mostly considered to be art. Conversely, the study of human anatomy in the renaissance period was an essential component of an artist’s training, as exemplified by the likes of Leonardo Da Vinci. In this article, how disease— specifically breast cancer—has influenced art and vice versa will be discussed. Breast cancer is an emotive cancer; it is a disease that affects a visible sexual organ and is the commonest single cause of death of women between 40 and 60 years of age. However, this type of cancer was infrequently depicted in historical art. In most of recorded history, cultural norms have dictated that the breast is unexposed to protect modesty; therefore, only a doctor or an artist painting nude models would have had the opportunity to see any clinical signs of breast cancer. Nonetheless, in the few pieces of art in which breast cancer has inadvertently been the subject of artistic creation, interpretations have been controversial. One of the most famous paintings that depict breast cancer is the oil-on-canvas piece by Rembrandt Bathsheba Bathing (figure 1). According to the Bible (II Sam 11: 2–17), King David saw beautiful Bathsheba bathing. She was the wife of Uriah the Hittite who was away serving in his army. The King ordered Bathsheba to the palace and soon afterwards she became pregnant. In the painting, Bathsheba has just read a letter from King David summoning her to the palace. An Italian surgeon first suggested 1 that Rembrandt might have depicted breast cancer in his painting— accurately showing the clinical signs of the fatal disease from which his model and mistress, Hendrickje Stoffels, was suffering. The painting is discussed at length in several papers and is used on the cover of the book Women, Cancer and History by James S Olson. The Italian diagnosis has not gone unchallenged: tuberculosis 2 and lactational mastitis 3 have been suggested as differential diagnoses. Rosenzweig suggested that Michelangelo depicted a breast completely infiltrated with cancer in his sculpture La Notte (figure 2). 4 However, this could be an artistic stylisation of a breast on a mostly masculine form to which the acclaimed sculptor was accustomed. Carlos Hugo Espinel 5 claimed in a full-length article that Raphael was the first to depict signs of breast cancer in his painting of Fornarina (figure 3). However, Michael Baum 6 debated these claims, giving clear and plausible explanations for each of the characteristics described by Espinel: first, the position of the index finger is a classic pose that can easily create a dimple even in a normal breast; and second, breast cancer never gives rise to a bluish tinge. Baum also warns of the difficulty in the diagnosis of cancer in art and cites the Miracle of San Carlo Borromeo (circa 1610, Margherita della Guardia Veneta, Museo del Duomo, Milan, Italy) by Il Cerano in which a breast cyst is mistakenly depicted as a cancer that is miraculously cured. Figure 1: Bathsheba Bathing by Rembrandt Harmensz van Rijn (1606–1669) Louvre, Paris, France. Oil on canvas, 142×142 cm, 1654. Figure 2: La Notte by Michelangelo di Lodovico Buonarroti Simoni (1475–1564) Sagrestia Nuova, San Lorenzo, Florence, Italy. Sculpture. ArtReach http://www.breastcancerfund. org/site/pp.asp?c=kwKXLdPaE&b =83002 Visual Art http://www.breastcancerfund. org/site/pp.asp?c=kwKXLdPaE&b =108088 Breast Cancer Answers Art Gallery http://www.canceranswers.org/ gallery/index.htm Jo Spence http://hosted.aware.easynet. co.uk/jospence/ Matuschka http://www.matuschka.net/ With permission from Sagrestia Nuova, San Lorenzo, Florence, Italy Louvre, Paris, France/Giraudon/The Bridgeman Art Library