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Earlier this week, Kate Middleton bent down before a bare-breasted female citizen of Solomon Islands, and accepted the garland placed around her neck. Then, for a fleeting second, the Duchess of Cambridge suppressed what can only – and must – be described as a titter.

Naked boob giggling is usually a pastime of 13-year-old boys, but maybe the Duchess was expressing a finely tuned sense of the absurd, as her own breasts are at the centre of a tabloid scandal. Paparazzi shots of Middleton sunbathing topless ran in the French magazine Closer, outraging Buckingham Palace and eliciting Fleet Street's condemnation (the British press's daily invasion of the Duchess's uterus remains a-okay, however). Regardless, the pictures appeared in the Italian magazine Chi, which like Closer, is owned by former prime minister Silvio Berlusconi, who is staunchly pro-boob. Italian citizens interviewed by a news team on one street corner threw up their hands at the scandal and said – loosely translated – "They're just breasts! Iy iy iy iy! Relax-a!"

Therein lies the mammary conundrum: Are breasts a big deal or are they just boobs? It wasn't like Middleton's gynecologist released vulva video, nonetheless, the Royals won a court injunction halting further publication of the photos in France. The confusing cultural duality of breasts – biological necessity and sexy time (a.k.a. mother and whore) – may be distracting us from the much darker reality of a gland beset with illness, in need of a different kind of attention.

In the new book Breasts: A Natural and Unnatural History, author Florence Williams ruminates on the accepted notion of breasts as "courtship devices," aiding in natural selection and competition, a sign of female fecundity. But she finds that the big-boobs-win theory doesn't hold up. New Zealand researchers have conducted "eye-tracking" studies where the male eye lingers repeatedly on the breast, but it isn't picky; preference for size, shape, and even areola colour is all over the map.

And, as Kate herself saw in Solomon Islands, it's not every culture that sexualizes breasts at all times. Here, where sex sells, it's barely possible to see them as purely functional, which is why the recent cover of Time magazine with the breastfeeding three-year-old was so scandalous. Breast biting is reserved for grown-ups and the Internet, thank you very much.

A different breast story also made the British news last week. An actress named Lucy Holmes launched an on-line petition asking Sun editor Dominic Mohan to get rid of the topless "Page 3 girl." In a YouTube video, Holmes – seemingly motivated more by self-esteem than politics – tells the story of how lousy it made her feel as a kid to see her own body in relation to the Page 3 girls day after day. Even as someone who frequents the A shelves in the lingerie department, I've always been more fascinated than bothered by the ubiquity of big breasts. But soft porn and news make ridiculous journalistic bedfellows and Holmes is right to demand Mohan "stop conditioning [his] readers to view women as sex objects." The two-week-old petition has already gathered 25,000 signatories; one British bookmaker is now taking bets on when it will reach 100,000.

Side by side with the Middleton scandal, the story highlights the shifting currency of breasts, depending on who they belong to. The unknown Page 3 girls ply their breasts as entertainment. They're revealed for a quick, but probably meagre, buck, or in the hope of fame. These kinds of anonymous breasts – see: Hooters and Xtube – are readily available, and come cheap.

But celebrity breasts are part of the economics of scarcity: rarely seen, and more valuable for it. Any actress whose nude scene has been freeze-framed for eternity knows this, as do the institutions that profit from the peeping. The violation of privacy is inexcusable, but Middleton's pictures fascinate because the Royal image is so carefully orchestrated. A picture of a royal sunbathing nakedly – or grinding in a Vegas hotel room – is more than just fodder for sexual fantasy; it's a break from script, and an equalizing moment where the elevated celebrity is knocked down to our lowly, corporeal status. We're all the same with our clothes off.

But for all their heady symbolism, the present-day reality of breasts is grim. The alarming takeaway of Williams's book is that our breasts are killing us. A journalist, Williams went digging after discovering that her own breast milk was contaminated with chemicals like perchlorate, found in rocket fuel. She writes that we are carrying large sponges on our chests, perfect for absorbing toxins, and that the incidence of breast cancer in the United States has almost doubled since the 1940s. It's now the most common malignancy in women worldwide.

And yet, this stark reality gets cloaked when breasts are viewed as either a giggle or a taboo. October is Breast Cancer Awareness month. A noble cause, but often, breast-cancer campaigns pantingly play off exactly this mass of confused signals, fetishizing breasts or chuckling at them, and almost always wrapping an infantilizing pink bow around a serious disease.

Even though they're everywhere, we're not really seeing breasts. The Duchess and Fleet Street are right that boobs are a big deal, but they're tending the wrong scandal.

Clarification: This column refers to the book Breasts: A Natural and Unnatural History, by Florence Williams. Williams is an American author and her assertion that the incidence of breast cancer has almost doubled since the 1940s refers to U.S. statistics.

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