What Sex and the City Can Teach Us About Breast Cancer

On screen

In the later seasons of Sex and the City, the confident, quick-witted Samantha Jones is diagnosed with breast cancer. Viewers follow her through the emotional shock of the diagnosis and the realities of chemotherapy, including the loss of her hair. The storyline is played with Samantha's trademark humor and honesty, and it became one of the most talked-about cancer arcs on television.

The show is fiction, but the diagnosis it portrays is very real for many people. It's a good moment to step back from the drama and look at what breast cancer actually is.

The reality

According to the National Cancer Institute, breast cancer is cancer that starts in the breast. It can begin in one or both breasts. Breast cancer happens when cells in the breast grow without control, creating a mass called a tumor that may spread elsewhere in the body.

Breast cancer mostly affects females aged 45 and older, but anyone with breasts can get breast cancer. It is rare in children and in males.

The NCI explains that breast cancer can form in different parts of the breast:

• Glandular tissue — the milk glands, milk ducts, and lobules (the tiny glands that make milk). Cancers that start in the ducts are called ductal cancers, and cancers that start in the lobules are called lobular cancers. Most breast cancers are ductal cancers.
• Fibrous and fatty tissue (stroma) — the tissue that fills the spaces between the lobules and ducts and gives the breast its shape.
• The nipple — where a type of breast cancer called Paget disease of the breast can start.
• Blood vessels and lymph vessels — where inflammatory breast cancer and angiosarcoma can develop.

There are many types of breast cancer depending on where it begins and how far it has spread. When the abnormal cells stay within the lobules or ducts and have not spread, it is called carcinoma in situ. Invasive cancers have spread into surrounding breast tissue and can reach nearby lymph nodes or other organs. The NCI notes that most breast cancers are invasive.

What the story gets right — and what to remember

Sex and the City gets an important truth right: breast cancer treatment can be demanding, and its visible effects, like hair loss during chemotherapy, are part of many people's experience. The show also portrays the emotional weight of a diagnosis honestly.

But a television storyline is written for drama in a fixed number of episodes. In real life, breast cancer varies enormously from person to person — in type, in stage, in treatment, and in how someone feels along the way. Samantha's journey is one fictional story, not a roadmap for anyone's real diagnosis. Nothing here is medical advice.

Awareness, screening & prevention

The NCI's "What Is Breast Cancer?" page focuses on what breast cancer is and the tissues where it can form. It highlights that breast cancer mostly affects females aged 45 and older, while noting that anyone with breasts can develop it and that it is rare in children and males.

Because this particular NCI page is an overview of what breast cancer is rather than a screening or prevention guide, the most reliable next step is NCI's dedicated screening, causes, and risk-factor pages for breast cancer — and a personal conversation with a healthcare team about what's right for you.

Turning a story into something useful

A memorable character can open a door to real understanding. If Samantha's story makes you curious, let that curiosity lead somewhere useful: learn the facts from trustworthy sources, share what you've learned with the people you love, and talk with a healthcare team about your own questions. Supporting free, accurate cancer education helps make sure the next person who goes looking for answers finds real ones.

Questions to ask a healthcare team

• What type of breast cancer is being described, and where in the breast did it start?
• Has it stayed in place (in situ) or spread into surrounding tissue (invasive)?
• When should I begin breast cancer screening based on my personal history?
• What signs or changes should prompt me to check in with you?