The pink ribbon is an ever-present symbol of breast cancer survivorship in U.S. public culture, and over the past few decades there have been significant advances in breast cancer research and treatment (National Breast Cancer Coalition, 2013). Network news stories and magazine article reports on breast cancer are able to heighten awareness and reach a broad audience (Cho, 2006; Smith et al., 2009). However, cultural expectations, media representations, and the commercialization of breast cancer can be deceiving, often leaving out vital information related to types of cancer, treatment options, long-term recovery, and quality of life.

Amid this exposure and (mis)information, Black women continue to die from this disease more often than their White counterparts (American Cancer Society, 2013). Relevant research that points to various socioeconomic reasons for this health disparity abounds: Issues such as access to quality and affordable health care, breast cancer screening rates, attitudes toward mammography, consumers lacking medical knowledge, and the fact that Black women are in poorer health to start with contribute to this gap. Other studies in recent years have begun to focus on environmental stressors, the role of religion and spirituality, and cultural expectations of Black women. However, there has been limited attention to the confluence of faith talk (spirituality), strong Black womanhood, and breast cancer culture and how these variables influence breast cancer survivorship. There is an unhealthy intimacy that dwells within the convergence of these three variables in the lives of Black women breast cancer survivors. This essay looks at this intersection using Elisabeth Noelle-Neumann's spiral of silence theory.

The spiral of silence theory refers to the increasing pressure people feel to conceal their views when they think their opinions are unacceptable. Constant repetition of a single point of view in media depictions of what breast cancer survivorship looks like can influence perceptions of public opinion and intensify the pressure for women to keep differing perspectives private (Noelle-Neumann, 2009; Littlejohn & Foss, 2011). When critiquing Noelle-Neumann's theory, Khoshrou and Sadeghi (2013) explicitly direct attention to the simplicity of its application at the exclusion of cultural influences. I use Noelle-Neumann's theory for its simplicity while including the cultural nuances that influence Black women's communication dynamics. Breast cancer culture, faith talk, and the myth of the strong Black woman are cultural variables that create nuances in how Black women communicate about their health to family, friends, and even to themselves.