NCCC to Use Lemons to Educate Women about Breast Cancer Detection

October 01, 2012
Lebanon, NH

Dartmouth-Hitchcock Norris Cotton Cancer Center (NCCC) has put a yellow tint on its October breast cancer awareness efforts, a month usually draped in the color pink.

Northern New England's only National Cancer Institute-designated Comprehensive Cancer Center has equipped its 16 New Hampshire and Vermont locations with posters and pamphlets that transform lemons from fruit into a teaching aid.

"We want women to be educated, empowered, and healthy," said Telisa Stewart, MPH, DrPH, NCCC director of community education and prevention. "Women need to know when to take action and what steps to take."

Dozen lemons in an egg carton

The NCCC breast cancer campaign includes a poster that depicts a dozen lemons in an egg carton, each digitally manipulated to illustrate a possible sign of breast cancer, such as dimpling, inflammation, or indentation, since lumps are not the only signs of breast cancer. Another poster features a dissected lemon as the anatomy of the breast and compares the breast's features to soft beans and peas while pointing out: a cancerous lump is often hard and immovable like a lemon seed.

The detailed graphics used in the NCCC campaign were developed by London-based graphic designer Corrine Beaumont, who earned her PhD in graphic design perfecting and testing educational images that can be used in any country or any language.

The aim of these awareness materials is to convince women of all income and education levels about the importance of monitoring breast health. When detected at its earliest stages, 98 percent of women survive breast cancer. "The sooner you spot it - the easier it is to cure," said Kari Rosenkranz, MD, medical director, NCCC Comprehensive Breast Program. Rosenkranz, a leading breast surgeon in NH, says spotting breast cancer early gives women better treatment options. "At the earliest stage, treatment is often less severe and less aggressive."

Doctors recommend regular breast cancer screening for women 50-69 years old who have no signs, symptoms, or history of breast problems. Women with a family history of breast cancer or other risk factors should be screened even younger than 50.

Breast cancer screening, which usually relies on mammography, is considered safe and effective by leading organizations. It does, however, have a few drawbacks.

Breast cancer screening tests can lead to:

  1. False positives: Test results that may "look" like cancer, but after additional testing, prove not to be cancer.
  2. Over diagnosis: A positive test result for a slow-growing cancer that would never spread fast enough to cause serious illness or death.
  3. Missed diagnosis: Breast cancer screening tests can fail to detect cancer when it is present.

Deciding to have a screening test is a personal decision most women make after talking with a health care provider.

If a woman does not have a regular health care provider or health insurance, programs in each state can help qualified individuals receive free screenings in their local community.

Dartmouth-Hitchcock offers an on-line tool called "When Should I Start Having Mammograms" at It helps women consider the facts before they sit down to talk to their health care provider.

About Norris Cotton Cancer Center at Dartmouth-Hitchcock

Norris Cotton Cancer Center combines advanced cancer research at Dartmouth College and the Geisel School of Medicine at Dartmouth with patient-centered cancer care provided at Dartmouth-Hitchcock Medical Center, at Dartmouth-Hitchcock regional locations in Manchester, Nashua, and Keene, NH, and St. Johnsbury, VT, and at 12 partner hospitals throughout New Hampshire and Vermont. It is one of 41 centers nationwide to earn the National Cancer Institute's "Comprehensive Cancer Center" designation. Learn more about Norris Cotton Cancer Center research, programs, and clinical trials online at

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