'Take ownership of your condition': Australian women’s health and risk talk in relation to their experiences of breast cancer

Abstract

Western understandings of breast cancer are primarily shaped both by neo-liberal, individual-oriented approaches to health and illness and by ‘consumer-led’ health movements. In this ‘healthist’ context, diagnosis of breast cancer typically marks a crisis in women’s lives, which may prompt them to account for the development of the illness and reposition themselves as self-governing individuals who have control over their health and who can manage future ‘risks’. We present a thematic discourse analysis of interviews conducted in 2012 with 27 women across Australia who have had breast cancer. Using the lenses of ‘healthism’ and ‘risk management’ in this analysis, we identified a cultural discourse of ‘individual responsibility and empowerment’. Women utilised this discourse while ‘accounting’ for their illness by engaging in ‘health talk’ and ‘risk talk’. While many women emphasised the shock of the diagnosis in light of having been ‘always healthy’, others expressed the inevitability of ‘risk’ on the basis of individual behaviours or genetic history. This discourse provided women one way to explain and make sense of their illness, potentially enabling them to cope with the fear and uncertainty of breast cancer. Drawing on this discourse, women could also position themselves in socially desirable and empowered ways as responsible health consumers, as self-governing and as taking responsibility in dealing with the illness and remaining vigilant for recurrence. We discuss how this neo-liberal approach can be empowering, but also has the effect of positioning women as primarily responsible for managing their health and their illness.