A new photo series highlights the diverse experiences of breast cancer patients

(CNN) — For many people, being diagnosed with breast cancer, and undergoing surgery, brings about a period of grief for the loss of their figure as they’ve known it — among other things.

But Vanessa Gonzalez faced their double mastectomy with a calm certainty, and eventually even came to celebrate it.

Gonzalez, who is nonbinary, told CNN over the phone that their gender identity had been clear to them since age 5, but cultural norms kept them from fully expressing their true self.

“A year before getting diagnosed with cancer, I was already considering getting top surgery,” Gonzalez, a 41-year-old chef based in Los Angeles, said. “So when I found my lump (in 2021), probably the easiest decision out of this whole process was to remove my breasts. My journey after surgery looked a lot different than for most ciswomen,” adding that it helped them finally feel at home in their body.

Gonzalez is one of seven models currently featured in “Marks of Majesty,” a new photography project aimed at raising awareness of breast cancer, and the diverse population it affects. Its models — scouted by Stephanie Francis, the project’s co-director and designer — strike vulnerable, yet confident poses, revealing how cancer has transformed their bodies while also asserting themselves in their overhauled embodiment of beauty, body image and gender expression.

In the photos, many of the models have regal silver or gold metallic paint brushed across their surgical scars. The paint turns their bodies into “works of art,” said Julia Comita, the photographer and co-director behind the project, in a phone interview with CNN.

“Our hope is to raise awareness, first of all around breast cancer,” Comita told CNN, adding that she hopes the project’s dissemination will be impactful for others in their participants’ communities.

“What we learned doing this project is that a lot of people are not represented in breast cancer media. Often, it’s older White women, when there’s a broad range of individuals who are impacted,” Comita explained. “Most people (we worked with) were Black or of color, and they expressed to us that finding support, research and information for their communities is really slim.”

Each year in the United States, about 240,000 women and 2,100 men are diagnosed with breast cancer. Although the incidence rate of breast cancer is 4% lower among Black women than White women, Black women are 41% more likely to die from the disease, according to the American Cancer Society. Breast cancer is less common among Asian women than in other ethnic or racial groups, but the disease is the most commonly diagnosed cancer.

“We feel that creating images that are powerful and make you stop and look twice is a great way to invite people in who might not have previously been engaged in the conversation,” Comita said. “It was (also) a way to celebrate (the models) and do it in this fashion-forward way.”

Young adults with an ‘old’ illness

The average age of a patient at the time of a breast cancer diagnosis is 62, but many of the “Marks of Majesty” models learned of their health status in their 20s.

Eshaana Sheth was 27 when she was diagnosed with hormone receptor positive breast cancer in 2019. Breast cancer is hormone receptor positive when cancer cells have receptors — which the National Cancer Institute describes as binding proteins within the cell — that attach to progesterone or estrogen. The presence (or lack) of these hormones then impacts cancer growth in the cells, as well as treatment.

Sheth’s case also undercuts the common misconception that recovering from breast cancer is a one-and-done situation wherein someone is diagnosed, goes through surgery and treatment, then recovers and moves on with their life. Sheth remains on endocrine therapy — to prevent estrogen from helping her hormone receptor positive breast cancer cells grow — which negatively impacts her cognitive, sexual and sleep health and has made her post-menopausal at 32 years old. “It’s a nightmare at my age,” she said.

As a first-generation American whose parents immigrated from India, becoming “another statistical anomaly” made her feel like the universe was against her, said Sheth, a self-proclaimed multihyphenate working in modeling, screenwriting and filmmaking in LA and New York City, in a phone interview.

“There are a lot of triggering topics, especially around groups of women where they talk about things like periods or boobs that are just not applicable to me anymore,” she said. “I just sit there, and I don’t know what to say.”

“I’m also working on understanding my body sexually again, and not just like this broken and reconstructed thing,” she added. “I really try, through this process, to look at bodies more in terms of their function and the ability I still do have.”

Redefining beauty, femininity and gender

When Mariah Crenshaw was a teenager, she was often called “Mariah with the big breasts” — a nickname given to her by peers to distinguish her from other students with the same name at her high school. She was embarrassed by both the imposed, narrow identifier and the size of her bust; for years, she strove to hide it. But as Crenshaw grew older, she embarked on a self-love journey centered on the importance of accepting her natural figure.

“I thought I was over the hump when I finally embraced them,” Crenshaw, a model and storyteller in Louisville, Kentucky, said of her breasts. “However, the universe was like, ‘How much do you really love yourself?’ and put this roadblock of breast cancer in my way.”

The curveball caused Crenshaw’s body dysmorphia to reappear. And as a young Black woman, she felt isolated due to not seeing anyone who looked like her at the support groups she attended. But she has since found community in Black-led and –curated spaces, learned to love herself again and reconsidered what constitutes femininity and beauty.

“There’s beauty in who I am and what I have to offer,” she said. “Beauty can be in the way you carry yourself.”

Crenshaw wasn’t ready to give up her breasts at the time of her double mastectomy, she said, so she opted to subsequently undergo implant reconstruction — a common decision, as 81% of the reconstruction procedures in the United States are implant-based, according to a 2022 study.

But she said she might consider foregoing them in the future. “Would I go flat … 10 years from now, once the implants need to be changed or something like that? Yes,” she added, arguing that the option to not undergo reconstruction post-mastectomy often isn’t offered “because of the societal norms in how we interpret beauty.”

The journey of body image influenced by cancer was especially complicated for Laura Skarzout, a 42-year-old Florida-based mastectomy model and previvor who underwent seven reconstructive surgeries to fix the damage from the initial preventive double mastectomy she had at age 35.

“Regardless of how ‘botched’ my skin is, I love myself now,” Skarzout said. “It was actually really important for my daughters to see that too — that the way you view yourself has nothing to do with how other people view you.”

Highlighting how the models see themselves, particularly in ways they previously hadn’t, proved to be another meaningful outcome of the shoots, Comita said, noting that her project is ongoing — the “Marks of Majesty” website features a callout for more people to share their stories.

“I like that we were (featured as) people who have been impacted by breast cancer without looking either sad, like we’re dying, or like we’re about to go run a marathon or something,” Crenshaw, the Kentucky-based model, said. “It felt real, but it (also) felt elegant and editorial to me, and I’d never seen it in that light before.”

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