Breast cancer in Woman Sitting Half-Dressed beside a stove (1658) by Rembrandt van Rijn.

The baroque Dutch painter Rembrandt Harmenszoon van Rijn (1606–1669 CE) was acquainted with pathological modifications of the breast as shown in the canvas Bathsheba at her toilet (1654 CE); his model, Henrijke Stoffels, was depicted with discoloration of the left breast, peau d'orange and distortion of symmetry with axillary fullness. A diagnosis of breast cancer was initally proposed [1] but was later dismissed in favour of cancer mimickers (tuberculous mastitis [2], lactation mastitis following unsuccessful pregnancy [3], Mondor's thrombophlebitis [4]); this was essentially due to Henrjike's long survival (9 years after the depiction) fairly ruling out advanced breast cancer.

In this report we describe the case of right breast cancer in the state I/7 of Rembrandt's etching Woman Sitting Half-Dressed beside a Stove (1658 CE; Inv. Nr. B197) [5,6] (Fig. 1), This print exists in seven original states plus, at least, 24 reprints. Rembrandt was used to rework a single plate several times and to make prints from the same plate between various changes; these changes are named „states“. Knowing the number of each state is extremely important in terms of paleomedical diagnosis. Within the original states, prepared and promoted by Rembrandt for commercial purposes, there are two types which show a main difference in the presentation: one with a breast pathology (state I/7) (fig. A) – and one without (all remaining states) (fig. B).

Fig. 1

Differences in the representation of the right breast in Print B. 197 state I/7 and state VI/7. a: Print B. 197 (I/7) Woman sitting half-dressed beside a stove” (1658). Etching, burin and drypoint printed on Japanese paper with much surface tone in darker areas on, height: 228 × 187mm). “First state” (I/7) etching held by The British Museum, London, UK. (https://www.britishmuseum.org/collection/object/P_1848-0911-99) (Accession number: 1848,0911.99) © The Trustees of the British Museum. The woman shows the right breast strongly deformed, with retracted and cranially dislocated nipple; a lump can be appreciated at the superior and inferior outer quadrant of the breast. b: Print B.197 Woman sitting half-dressed beside a stove” (1658) (Accession Number: 24.74) by Rembrandt van Rijn held by the Metropolitan Museum of Art). Etching, burin, and drypoint, sixth of seven states (VI/7), 23 × 19.8 cm, (https://www.metmuseum.org/art/collection/search/392067). Inscribed on upper right (on the flue of the stove): “Rembrandt. f. 1658”. The same model is depicted but shows a normal right breast. Other several divergences, i.e. hat; oven, chamber pot, can be appreciated.

The “pathologic” etching shows the luminous figure of an adult woman in a large room. The model is bare until the waist and sits in full profile on a bed. The right arm is outstretched, the left rests on her left leg. A metal stove bearing a medallion of the mourning Mary Magdalene stands to her right. The woman's right breast appears deformed with nipple dislocation and retraction towards the right upper outer quadrant and an obvious lump of this and the lower outer quadrant strongly suggestive of breast cancer. The technical execution of the etching does not allow further interpretation. In contrast, the other type of this etching shows fairly normal breasts.

The etching has been suggested to show a scene in a hospital as evidenced by the large room with an ample stove [6]. The type of undressing of the female may represent a medical examination possibly witnessed by Rembrandt. Further confirmation of this assumption comes from a parallel etching by Rembrandt named Seated Naked Woman with a Hat Beside Her (1658 CE; Inv. Nr. B199) which depicts the same model [5] completely bare sitting on a chair in a position similar to that of the half-dressed woman, however, without overt breast pathology. One of the copies of this etching was dedicated to the surgeon's guild of Amsterdam [7], further confirming an association of the scene to a medical examination. Finally, Rembrandt's famous and magnificent paintings The anatomy lesson of Dr Nicolas Tulp (1632 CE) and The Anatomy lesson of Dr Johannes Deijman (1656 CE) uncover the long lasting relationship between the painter and the surgeons’ guild [8].

A previous publication suggested that the appearance of breast cancer is an artifact of the etching process, which produced the appearance of hard edges where previously there were only soft contour”. [9] This statement is not correct. As matter of fact, if the seven states of etching B. 197 are observed, it appears that the first state of seven (I/7) is the pathological one. Only from the second state (II/7) onward the breast assumes soft contour and not revers.

We therefore, suggest that the meticulous representations of pathological human organs, as the breast, were an integral part of Rembrandt's artistic production. However, for commercial reasons [7], the artist, who was living in poverty at the end of his life, also produced non-pathological versions of his etchings which may have been more easily vendible.