In recognition of Breast Cancer Awareness Month—a global campaign each October to raise awareness and funds for breast cancer research—the stories of Israeli women like Gali Michaeli highlight the ongoing fight against this disease and the innovative treatments aiding survivors in their recovery. From fascial manipulation to medical micropigmentation, breast cancer survivors in Israel are turning to cutting-edge health professionals to support their physical and emotional healing.
Just three months after returning to work from her second maternity leave, Michaeli was diagnosed with breast cancer. Her mother had faced the disease more than a decade earlier and discovered she was a BRCA gene carrier. Following her mother’s diagnosis, Michaeli got tested and learned she also carried the gene, which significantly increases the risk of developing breast or ovarian cancer.
After the birth of her second child, Michaeli had her ovaries removed—a standard recommendation for BRCA gene carriers. Soon after, she discovered a lump in her breast.
“I was diagnosed with triple-negative breast cancer,” Michaeli told The Media Line. “I had been debating whether to get a mastectomy and reconstruction because that is also something BRCA gene carriers do.”
Just 30 days after her diagnosis, she underwent a double mastectomy.
“For me, knowledge is power,” Michaeli said. “A lot of women are afraid of getting a BRCA diagnosis, so they procrastinate. Triple-negative is very aggressive, and if I hadn’t been tested early, who knows what could have happened?”
In Israel, about 467 new cases of breast cancer are diagnosed each month. Projections for 2024 estimate around 5,600 new cases, with approximately 1,000 deaths expected due to the disease and its complications. Breast cancer accounts for nearly one-third of all new cancer diagnoses in Israeli women each year.
One key reason behind the high rates of breast cancer is that more than 2% of Ashkenazi Jewish women carry one of three common mutations in the BRCA1 or BRCA2 genes, significantly increasing their lifetime risk of developing invasive breast cancer. Many women who learn they are carriers choose to undergo preventive surgery. While removing the breasts can be lifesaving, it often comes with intense physical pain and can negatively affect a woman’s self-esteem, even when reconstructive surgery is an option.
Physiotherapist Natalie Brettler, who works with Olympic gymnast Linoy Ashram and the Israeli rhythmic gymnastics team, has dedicated much of her practice to helping women through the innovative fascial manipulation technique. From her clinic in Herzliya, Brettler is recognized as a global expert in this method, which reduces pain, improves functionality, and helps women regain active, meaningful lives.
Doctors save the patient’s life, and we save her quality of life
“If a woman did any surgery, radiation or chemotherapy, we are there to treat her afterward,” Brettler told The Media Line. “I always say that doctors save the patient’s life, and we save her quality of life.”
Physiotherapist Natalie Brettler. (Courtesy)
Fascial manipulation focuses on the body’s connective tissues. Muscles, nerves, and blood vessels are all wrapped in connective tissue, and after surgery, patients may develop adhesions or restrictions between the layers of myofascial tissue, contributing to their pain. Brettler says these issues “interfere with muscle function and reduce the range of motion.”
After breast cancer, patients may also experience decreased sensation in the chest area, as well as edema, or swelling caused by fluid retention.
Fascial manipulation is a soft tissue therapy where the health provider assesses movement limitations caused by the fascia. Physiotherapists then apply pressure using their hands or special instruments to release these restrictions. Other techniques, such as massage, may also be incorporated to treat the body.
Pain in the shoulder, frozen shoulder, chest pain, reduced range of motion, nerve sensations, and edema—all of these symptoms can be treated,” Brettler explained. “Patients feel improvement immediately after the first treatment. The number of sessions needed depends on the individual, but there is usually a dramatic change.”
Michaeli is one of the women who tried fascial manipulation after her mastectomy. She described the treatment as “magic,” sharing that “I went from not being able to lift my right arm to lifting it all the way within six weeks.”
Another patient, Eden (who requested her last name not be used), is just 22 years old and underwent a similar mastectomy.
“The recovery from surgery was harder than I expected,” she told The Media Line. “After the operation, I could barely move my arms and felt pressure, itching, and pain around the surgical areas, including my neck and back. About six weeks after surgery, I went to Natalie’s clinic. I had heard of these treatments before but didn’t realize how crucial they would be for me.”
Eden attended weekly sessions at the clinic and noticed significant improvement each time. The pain in her neck and back eased, her breasts became softer and more natural as the implants integrated with her body, and her scars improved. She also emphasized the mental benefits of the treatment.
“The treatments helped me return to my normal life at home and work, adjust to the new sensations in my breasts, and accept my new body,” she said.
Brettler’s clinic has helped thousands of Israeli women, and she also trains doctors both in Israel and abroad, collaborating with leading breast cancer specialists. Although her Herzliya clinic is private and doesn’t directly accept insurance, Brettler noted that fascial manipulation is covered by insurance in general, and patients can find options through their health funds.
“There is a solution,” Brettler said. “Women need to know that there are ways to improve their quality of life after the harsh procedures they’ve been through.”
‘Remember to love yourself’
Jerusalemite India Abraham fills a different but important role for many women who undergo mastectomies. A tattoo artist, she performs something called medical micropigmentation, which uses skin tone pigments to create 3D nipples for those who have undergone preventive surgery or survived breast cancer.
Artist India Abraham shares a healing embrace with a client after a scar camouflage session. (Yitz Woolf)
“We use a lot of light and shadows and very fine pigment implantation in order to create the illusion of a 3D nipple,” Abraham told The Media Line.
Sometimes, when women know they will be having a mastectomy, they come in beforehand so Abraham can take photos to recreate their nipples as closely as possible to their original appearance. In other cases, women request unique additions, like their children’s initials or a heart, as symbols of strength and survival.
“It becomes an experience where they feel they’ve survived something horrific, and they’re trying to regain their confidence,” she said.
Abraham originally trained as a scientist, holding a master’s degree in public health and biology, and previously worked as a cancer researcher. However, she also wanted to explore her artistic side. When she discovered medical micropigmentation, it felt like the perfect blend of both worlds.
Abraham explained that, as an immigrant in Israel, she found the procedure is not well-known there. Currently, it’s not covered by national health insurance funds, so women who can’t afford it must either find a sponsor or pay out of pocket.
Still, she believes this service is essential for many women.
“Many women struggle with self-confidence and body image. Some even feel guilty about wanting this kind of care,” Abraham said. “I’ve had several women say, ‘I shouldn’t do this,’ especially when the war broke out. Many had appointments lined up for their tattoos, but after the war started, they said it felt selfish to go through with it. I asked, ‘Why would that be selfish?’ They said, ‘With everything happening, why should I care about myself when others are suffering?’”
Remember to love yourself, despite everything you’ve gone through, to love yourself and feel whole again
Her biggest takeaway is to “remember to love yourself, despite everything you’ve gone through, to love yourself and feel whole again.”
‘I was terrified’
Eden believed from a young age that she was destined to get cancer. Both her mother and grandmother died of breast cancer, and she felt sure that “my turn would come, too.”
“This thought continued to trouble me as I grew older,” she said.
At 20, Eden tested positive for the BRCA gene and began a close monitoring routine—including ultrasounds, MRIs, and mammograms—which are vital to early detection and can save lives.
“The monitoring process was stressful, and I felt like every test result would bring the news that I had cancer,” she recalled. “One thing that kept me going was knowing that if my mother had undergone these screenings, she would still be alive.”
As a BRCA carrier, Eden decided to have a mastectomy and reconstruction as soon as she learned she was a carrier, though she assumed she would wait a few years. But at 22, an MRI raised concerns about a potential tumor. Although it turned out to be a false alarm, it pushed her to undergo the surgery that same year. The procedure reduces the risk of breast cancer by 90% and offers peace of mind and a better quality of life.
“I was terrified, and the uncertainty about the outcome was significant,” Eden admitted. “But I chose excellent surgeons who made me feel safe and in good hands.”
“The first thing I remember after the surgery, while still under anesthesia, was a sense of relief,” she continued. “The constant burden I had carried was lifted. I felt my mother’s presence in those moments, and I knew she was proud of me.”
Michaeli has maintained a positive outlook, even after enduring three-and-a-half months of chemotherapy while her husband was on reserve duty. During that challenging time, she credits much of her resilience to focusing on wellness—for both herself and her family.
“I leaned into doing everything necessary—using all the medical insurance on offer, the best physical therapists, getting help at home, working as much as I possibly could, and staying physically active,” she said.
Now, she considers herself resilient.
Breast cancer sucks—any cancer sucks—but there is a lot you can do
“Breast cancer sucks—any cancer sucks—but there is a lot you can do,” she concluded. “A diagnosis doesn’t have to be the end of the world, but you have to take care of yourself and let others take care of you.”