Iconodiagnostic pitfalls for abnormal senological features in paintings by Dürer, the Le Nains, and Barry

Background

Artistic representations of suspicious breast nodules, such as tumors, have often been examined and debated. This approach is nevertheless subject to sources of bias that weaken the “dramatic” nature of certain iconodiagnosis.

Methodology

We looked at three masterpieces of Western art that have not, to the best of our knowledge, been examined previously in this context: “Adam and Eve” (c. 1507) by Albrecht Dürer; “Venus in Vulcan's forge” (1641), by the Le Nain brothers; and “Jupiter and Juno on Mount Ida” (c. 1795), by James Barry. After a brief description of the origins of the works and the cases, we discuss some putative abnormal senological features and the corresponding iconodiagnostic pitfalls with regard to the medical-artistic literature.

Results/Discussion

Eve's retraction of the nipple, associated to a voluminous axillary bulge and a dark dimple in the lower-outer quadrant, has to be balanced with the stylistic curvature of the finger and falling shoulder line, echoing to a potential risk of misdiagnosis due to the proper influence of artistic style. As for Venus, a dark dimple, reinforcing the impression of a loss of curvature associated with a putative mass in the upper-outer quadrant, might result from a simple shadow effect. Lastly, Juno, in a variation of the antique pose of the Venus Pudica, indicates a breast nodule by almost palpating it with her ring finger. The discoloration of the pigment over a possibly damaged structure might have induced an impression of relief. However, an engraving features a superposable accentuation in this region that is preferentially affected by breast tumors.

Conclusion/Perspectives

These three cases illustrate, from an educational standpoint, certain methodological limitations that must be taken account in the sequential iconodiagnosis process. These presumed artefactual abnormal senological features also reflects the difficulty of finding reliable, written, etiological information on mammary masses in women throughout the ages.