Because of Rubens’s high reputation, an inaccurate depiction of the model would be unlikely. Indeed, a breast mass would not have been intentionally drawn. In accordance with Rubens’s pursuit of realism, it is our opinion that he realistically painted the mass in the model’s breast. The attempt of a retrospective diagnosis of breast tumors in classic paintings is highly challenging. There are four aspects commonly raised in establishing a diagnosis.1–3,5
We observe that the breast tumor is soft, lobulated, irregular at the margins, with no skin retraction, no skin surface discoloration, nor “peau d’orange” present. Visually it does not correspond with infection or traumatic hematoma, it is not uniform, it is with irregular margins, and it does not have the features of a malignancy.
The Artist’s Intention
An intentional, rather than inadvertent inclusion of a deformed breast in a beautiful woman (likely the muse or the lover of the painter himself) makes no sense. Why would the painter not include a perfect model? Why wouldn’t he replace, if recognized, a “sick” image with a “healthy” representation?
Uncommon breast conditions such as Mondor’s disease3
or mammary deformities with typical aspects of malignancy have been previously detected in Rubens’s paintings involving two of his Three Graces, Delilah, Eurydice, and Diana pursued by the satyr.1
Despite the visible difference with the benign tumor herein reported, these findings confirm the familiarity of Rubens in the depiction of his models’ breasts and his extreme realism. There is no known written diagnosis in any of the Rubens portrayed cases, including in this “Judith with the Head of Holofernes
Indeed, we have no way to correlate the depicted image with clinical signs. Our diagnosis is of benign disease, with a differential diagnosis among giant cyst, fibrocystic disease, giant fibro-adenoma, adenosis, phyllodes tumor, hamartoma, lipoma, hemangioma, adenomyoepithelioma, neurofibroma, and pseudoangiomatous stromal hyperplasia.
Recognition of the Model
A collation of all the models depicted by Rubens in which breast diseases have been recognized (Figure 3
) does not allow any clear identification of the sitter of the portrait here referenced.
A collation of all models depicted by Rubens in which breast diseases have been recognized.
Art historians give credit to the theory that the Fourment sisters were used as models.3,6 Hélène Fourment (the second wife of Rubens) served partly as the model for numerous portraits, including the left Grace. She was born in 1614, and her sister Susana in 1599, so we should exclude that Rubens used his second wife or his sister-in-law as models for the Judith.
Instead, the first wife of Rubens, Isabelle Brant, has facial features similar to the Judith (Figure 4). She died in 1629 of plague 12 years after the Judith depiction, an event that would support our theory about the benign nature of the mass. There is no portrait other than Figure 4 (right) in which the breast of Isabelle may be evaluated. Rubens or his contemporary art historians did not leave any written documents that could contribute in this debate.
A Comparison between the Judith with the Head of Holofernes (left) and the Portrait of Isabella Brant (right) by Rubens (c.1625), oil on canvas.