PITTSBURGH — October is Breast Cancer Awareness Month, and I have breast cancer. The country is fully pinked out in support of breast cancer screening and research, and though I know all the pink is meant to make me feel good, to tell me that the entire country has my back, I actually find it profoundly alienating. Pink is not a serious color, though cancer is a very serious disease. Pink is about femininity; cancer is about staying alive.

I am lucky, if one can say that, within the context of possible cancer diagnoses. My breast cancer is small, has the tumor markers most favorable for treatment (estrogen- and progesterone-positive, HER2-negative) and is very slow-growing. A friend of mine, a doctor, trying to allay his anxiety and mine, joked that based on these results, I didn’t really even have breast cancer.

But breast cancer, even when one has a good prognosis, always raises the possibility of mastectomy, a surgery that removes the patient’s disease but is also said to disfigure her in a way that can compromise her femininity. The question that looms, reinforced by the ubiquitous pink, is whether a woman who has lost her breasts to mastectomy will still be a whole woman.

I have to say, speaking as a breast cancer patient, that the question never crossed my mind. I am not worried about losing my femininity to breast cancer surgery; I’m worried about losing my future to the disease. The real worry with breast cancer is metastasis: spread. And even though my present prognosis is good, there are reasons prophylactic double mastectomy would not be an unreasonable choice for me. However, after genetic testing and an M.R.I., I chose lumpectomy, with radiation, instead of mastectomy. Avoiding major surgery made the most sense in my specific situation; that mastectomy would threaten my womanliness did not factor in.

It’s interesting, that contrast between the frivolousness implied by femininity and the solemnity that marks a diagnosis of cancer. I’m an oncology nurse turned hospice nurse, and though I’ve seen many cancer patients return home to live their lives, I’ve seen more than a few of them die of their disease. It is not an abstraction, nor an exaggeration, to describe cancer as a killer.

And it’s that fear of cancer’s potential deadliness that overwhelmingly preoccupies all the breast cancer patients I’ve heard from since I received my diagnosis in mid-September. A colleague who has had a couple of biopsies since her treatment, but no new disease, wrote eloquently to me about how tai chi and dark chocolate help tamp down her fear that her cancer will return. A friend reminded me that her mother has outlived her diagnosis by over 20 years. And a friend of friends, who chose to have a double mastectomy, spoke of the enormous peace of mind the operation gave her and her sister, who also had breast cancer.

What resonates in each of these stories is two words: I lived. These women survived their cancer and keep on living.

In my own work in oncology, I primarily took care of patients with what we call liquid tumors: leukemia, lymphoma. We say in oncology that bad diseases require bad treatments, meaning savage and harsh, and treatments for acute leukemia are very bad. The chemotherapy causes patients to lose their hair, develop terrible mouth sores, suffer gastrointestinal distress and see their immune systems compromised.

I never, though, had a patient whose worry about those side effects came close to her worry about the disease. Being preoccupied with saving one’s life produces a myopia, in which other worries unrelated to one’s possibly imminent death fall away.

I did ask my husband, “If I lose my breasts, will you love me the same way?” I was half-joking, but the question was also ridiculous because I knew the answer. Knew it: “Yes.” Still. I feel that my asking it resulted from a kind of primordial sexism that, despite my best efforts, continues to infect my thoughts. The association of femininity and breast cancer is pernicious, because it genders the disease, meaning that a diagnosis of breast cancer marks patients as women first, people second. It implies that our womanliness is diseased, not our bodies.

“Be more than pink,” the Susan G. Komen website says, with links to information about supporting breast cancer research. The phrase suggests that pink doesn’t tell the whole story of breast cancer. I would take that statement further, arguing that it insults breast cancer patients to conjoin our femininity and this frightening disease.

My cancer was diagnosed via screening, a callback after my yearly mammogram. The tech finished the follow-up ultrasound, and then the radiologist, after a wait, came in. She stood a long time, saying nothing, and I realized belatedly that her silence resulted from concern. Because then she said, “We see a mass here at 9 o’clock.” I cried in the screening room while the tech held me, as tightly as if I were her own child, and I didn’t fear for some ephemeral sense of girlishness or sexiness, but rather for my life.