Mary Ann Nilan shaved her head on her 40th birthday, before chemotherapy, as she didn't want to lose her hair bit by bit. Mary Ann was diagnosed with breast cancer at the age of 39. She asked a photographer to record the process of her chemotherapy, double mastectomy and reconstruction implant surgery. Breast cancer is the most common cancer among women and the second leading cause of cancer death in women. In 2005 over 41,000 died from the disease in the US alone, but earlier diagnosis and improved treatment would appear to be driving death rates down.

A priest holds Mary Ann Nilan's hand as she awaits the last of eight chemo treatments. Mary Ann was diagnosed with breast cancer at the age of 39. She asked a photographer to record the process of her chemotherapy, double mastectomy and reconstruction implant surgery. Breast cancer is the most common cancer among women and the second leading cause of cancer death in women. In 2005 over 41,000 died from the disease in the US alone, but earlier diagnosis and improved treatment would appear to be driving death rates down.

Mary Ann Nilan with a verse from St Paul that she wrote on her stomach to be read by doctors performing the mastectomy: "For when I am weak, it is then that I am strong". Mary Ann was diagnosed with breast cancer at the age of 39. She asked a photographer to record the process of her chemotherapy, double mastectomy and reconstruction implant surgery. Breast cancer is the most common cancer among women and the second leading cause of cancer death in women. In 2005 over 41,000 died from the disease in the US alone, but earlier diagnosis and improved treatment would appear to be driving death rates down.

Mary Ann Nilan closes her eyes and says the rosary, during a painful injection of saline into tissue expanders that will stretch her skin to make way for implants. Mary Ann was diagnosed with breast cancer at the age of 39. She asked a photographer to record the process of her chemotherapy, double mastectomy and reconstruction implant surgery. Breast cancer is the most common cancer among women and the second leading cause of cancer death in women. In 2005 over 41,000 died from the disease in the US alone, but earlier diagnosis and improved treatment would appear to be driving death rates down.

After her double mastectomy Mary Ann Nilan was less upset by the damage than she had expected. Mary Ann was diagnosed with breast cancer at the age of 39. She asked a photographer to record the process of her chemotherapy, double mastectomy and reconstruction implant surgery. Breast cancer is the most common cancer among women and the second leading cause of cancer death in women. In 2005 over 41,000 died from the disease in the US alone, but earlier diagnosis and improved treatment would appear to be driving death rates down.

Mary Ann Nilan examines her breasts after her final painful injection of saline into tissue expanders that will stretch her skin to make way for implants. Mary Ann was diagnosed with breast cancer at the age of 39. She asked a photographer to record the process of her chemotherapy, double mastectomy and reconstruction implant surgery. Breast cancer is the most common cancer among women and the second leading cause of cancer death in women. In 2005 over 41,000 died from the disease in the US alone, but earlier diagnosis and improved treatment would appear to be driving death rates down.

A nurse locates a port for a saline injection. Mary Ann Nilan was diagnosed with breast cancer at the age of 39. She asked a photographer to record the process of her chemotherapy, double mastectomy and reconstruction implant surgery. Breast cancer is the most common cancer among women and the second leading cause of cancer death in women. In 2005 over 41,000 died from the disease in the US alone, but earlier diagnosis and improved treatment would appear to be driving death rates down.

Mary Ann Nilan is amazed by the shape of her new breast implants. Nilan was diagnosed with breast cancer at the age of 39. She asked a photographer to record the process of her chemotherapy, double mastectomy and reconstruction implant surgery. Breast cancer is the most common cancer among women and the second leading cause of cancer death in women. In 2005 over 41,000 died from the disease in the US alone, but earlier diagnosis and improved treatment would appear to be driving death rates down.

Mary (12) performs the daily ritual of measuring her mother's hair growth. Mary Ann Nilan was diagnosed with breast cancer at the age of 39. She asked a photographer to record the process of her chemotherapy, double mastectomy and reconstruction implant surgery. Breast cancer is the most common cancer among women and the second leading cause of cancer death in women. In 2005 over 41,000 died from the disease in the US alone, but earlier diagnosis and improved treatment would appear to be driving death rates down.

After chemotherapy, Mary Ann Nilan's hair grew back completely. She is pictured with her chidlren Mary (12) and Eddy (11). Mary Ann was diagnosed with breast cancer at the age of 39. She asked a photographer to record the process of her chemotherapy, double mastectomy and reconstruction implant surgery. Breast cancer is the most common cancer among women and the second leading cause of cancer death in women. In 2005 over 41,000 died from the disease in the US alone, but earlier diagnosis and improved treatment would appear to be driving death rates down.

Nature,3rd prize