Miss You Already (2015): Breast Cancer and Friendship

Milly and Jess have been inseparable since childhood in London. Milly is the glamorous, chaotic one. Jess is steadier, and quietly trying to conceive.

Milly has been putting off a check-up. She is told a breast lump is malignant and begins chemotherapy. Jess sits through it with her, while concealing that her own IVF has worked. The results push the surgical plan from lumpectomy to a double mastectomy. Milly's marriage and her sense of herself come apart. She starts an affair and pushes Jess away.

Their friendship ruptures on the Yorkshire moors. The two are still estranged when Milly's headaches turn out to be the cancer having reached her brain. She loses much of her sight and moves into a hospice, with one goal: to be there when Jess gives birth. She makes it, meets the baby, and dies shortly afterward.

Spoilers throughout. This page says how Miss You Already ends.

The film is precise. The error is in the summaries written about it.

On screen, a consultant explains that the plan is moving from lumpectomy and radiation to mastectomy. The reasons given are that the cancer is triple negative, and Milly's genetic testing results. Later an MRI confirms the cancer has reached her brain, and Milly repeats the phrase "metastatic brain tumors" back at her friend. Both facts are stated, not inferred.

What is not in the film is remission. The word never appears. One formulation has circulated widely: that her breast cancer was in remission while she also had fatal brain tumors. It originates in a plot summary and has been copied into derivative sites. It is internally contradictory on its own terms.

The film shows a continuous progression instead. A malignant lump, chemotherapy, escalated surgery, a reconstruction she never becomes well enough to have. Then the headaches, an MRI, and the news.

One more thing is worth flagging. A character does say "you had brain cancer" at one point. That is Jess, a lay friend, speaking loosely. It is characterization, not the film's diagnosis.

NCI defines triple-negative breast cancer as the absence of staining for estrogen receptor, progesterone receptor and HER2.

That is a statement about what is missing: none of the three markers is present. The label describes the tumor's biology and can shape which treatments are used. Ask your care team what it means for the plan. See what triple negative means for how the result reads on a pathology report.

Treatment plans for breast cancer depend on its type, including whether it is triple negative. NCI's PDQ summary groups breast cancer as hormone receptor positive, HER2 positive or triple negative (ER, PR and HER2 negative). Ask your care team how the result shapes the plan for your own cancer. This page does not give trial figures or drug choices, because we could not confirm them in an opened source.

This is the confusion the film gets right and its own characters get wrong.

When breast cancer spreads to the brain, the tumors there are made of breast cancer cells. The disease is still breast cancer. It is treated according to breast cancer biology, not according to a cancer that started in brain tissue. That general rule is covered in a cancer keeps the name of where it started, and what it means day to day is in brain metastases.

The social wreckage, rather than the illness. The friend who is exhausted and resentful and cannot say so. The husband who cannot look at his wife's body. The children who ask whether their mother is dead.

Milly is written as difficult, vain and often unkind while dying. That is a rare refusal of the noble-patient template. The physical detail is specific rather than tasteful: the post-op bra, the wig, the reconstruction always one hurdle away, then the cane and the lost sight.

The disease moves at the speed of the friendship plot. Estrangement, reconciliation and terminal news arrive in a sequence built so that Milly's decline and Jess's pregnancy peak in the same week. The late loss of vision is deployed mainly for visual poetry. The hospice admission is compressed and well lit. The childbirth crosscut is a construction, not an observation.

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Miss You Already gets the medicine right and has been summarized wrong. There is no remission in it. What there is, unusually, is a dying woman allowed to be selfish and awful, and a friendship that survives her being it.

• NCI — Breast Cancer Treatment (PDQ®), Health Professional Version

This page discusses Miss You Already for education. It is not medical advice, and nothing here is a judgement of anyone's real medical care. Spotted an error? Please email corrections@cancerexplained.org.