Ma ma (2015) and Breast Cancer on Screen

Magda is an unemployed primary school teacher in Madrid. In the opening scene a doctor, Julián, examines her and finds a lump. She is told she needs chemotherapy and then a mastectomy. Her husband has already left her.

Spoilers throughout. Magda's illness shapes every choice in the film, the last one included.

Her son Dani is football-mad. That is how she meets Arturo, a scout, at a children's match — on the same day his wife and daughter are in a car crash that kills the girl. Magda and Arturo become each other's support, then a couple.

She gets through treatment. Shaved head, wig, prosthetic breast, plans for reconstruction. She is told her chances are good. Then she becomes pregnant. The cancer returns and spreads. She chooses to carry the baby rather than take treatment that would end the pregnancy. She gives birth to a daughter, Natasha, and dies not long afterwards. The film closes on Arturo, Dani and the baby.

A few things land, and they are the physical ones.

The opening examination is close to how it goes. A lump is felt, and a plan appears fast. The film does not skip the body either. There is hair loss, a wig, a prosthetic breast, and talk of reconstruction. There is the specific grief of losing a breast, which is not the same as the fear of dying and does not get the same sympathy.

Magda protects her son from information. She performs cheerfulness for everyone around her. Both are extremely common and rarely dramatised. Penélope Cruz plays the exhaustion well, even when the script does not ask for it.

The dilemma at the centre of the film is real, and worth spelling out properly.

Breast cancer during pregnancy is uncommon but not rare. NCI puts it at about 1 in every 3,000 pregnancies, most often in women aged 32 to 38. It is also harder to spot. Pregnancy makes breasts larger, more tender and lumpier, and denser tissue is harder to read on a mammogram. Most women who are diagnosed while pregnant find the lump themselves.

Being pregnant does not stop treatment. NCI describes what is possible. Ultrasound is usually the first test, and mammograms and biopsies can be done safely. Women with early-stage cancer are usually treated much as anyone else would be, with the timing adjusted. Surgery can go ahead. Certain chemotherapy can be given after the first three months, though it is avoided in the last few weeks before delivery. Radiotherapy is normally delayed until after the birth. Hormone therapy, targeted therapy and immunotherapy are usually not given, because they can harm a fetus.

The hardest situation is Magda's: advanced disease that needs treatment immediately. NCI is direct that ending a pregnancy may be considered then. That is a decision for the woman, made with a team who can tell her what each option costs. The film is right that it is agonising and that the choice is hers. It is wrong to imply there is nothing in between.

The film leans hard on positive thinking, as though a good spirit changes what the disease does. It does not.

This matters more than it sounds. If outcome follows attitude, then a person who gets worse has somehow failed, and their family can be left believing they did not try hard enough. That is a cruelty dressed as encouragement. Mood affects how treatment feels and whether people keep going to appointments. It does not affect whether cells divide.

The medicine is thin elsewhere too. Recurrence and spread arrive as a plot beat. There are no scans, no discussion of options, no palliative care. Magda stays radiant, mobile and articulate through chemotherapy, then through terminal disease and a pregnancy at the same time. None of that feels the way it looks.

Screening is never mentioned in the film, which is a strange gap for a story that starts with a lump.

These are the signs worth an appointment:

• A new lump or thickening in the breast or armpit.
• A change in the size or shape of a breast.
• Dimpling or puckering of the skin.
• Skin that is red, flaky, or like orange peel.
• A nipple that turns inward.
• Discharge other than milk, especially if it is bloodstained.
• Breast or nipple pain that does not settle.

Most lumps turn out not to be cancer. A new one should still be checked rather than watched.

Screening means testing people with no symptoms. If you have already found something, you need assessment instead, and saying so gets you seen faster.

The US Preventive Services Task Force recommends a screening mammogram every two years for women aged 40 to 74 at average risk. That is a grade B recommendation. NCI's screening summary says there is evidence that mammography decreases breast cancer deaths in women aged 50 to 69, and that the benefit for women aged 40 to 49 is uncertain.

Some women should not be on the routine schedule at all. A BRCA1 or BRCA2 change, a strong family history, or past radiotherapy to the chest all call for a plan worked out with a specialist. That usually means starting earlier and using MRI as well as mammography.

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Ma ma is a tearjerker first and a medical account a distant second. Watch it for Cruz. Do not take it as a guide to what a pregnancy and a cancer diagnosis together would mean for you, because the real answer has far more options in it than the film allows. If you find a change in your breast, book the appointment this week. Ma ma cannot tell you what to watch for, but screening and possible warning signs can.

• NCI — Breast Cancer Treatment During Pregnancy (PDQ®), Patient Version
• NCI — Breast Cancer Screening (PDQ®), Health Professional Version
• USPSTF — Breast Cancer: Screening (2024)
• NCI — Breast Cancer Symptoms

This page discusses Ma ma for education. It is not medical advice, and nothing here is a judgement of anyone's real medical care. Spotted an error? Please email corrections@cancerexplained.org.