How an image and a soon-to-be-app are going to change breast cancer in 2018

When California patient Erin Smith Chieze asked her friends on January 10, 2017 to stop posting hearts and instead post a photo of 12 lemons in support of breast cancer awareness, the unexpected happened: the photo became a global phenomenon.

Seen by over 200 million people over the past year, it also became one of the top 10 most popular tweets of 2017. Why? Because it explained that there was a lot more than a lump.

In a 2017 survey of 9,000 women, just 2% could name up all the signs of breast cancer. But thanks to this #knowyourlemons campaign developed by the nonprofit charity Worldwide Breast Cancer, that number is now changing. Finding a symptom early can lead to less severe treatment and a better outcome. Women and men cited the campaign for helping them get checked—and diagnosed. Patients who wish they had seen the campaign earlier praised it as a lifesaver for others:

"Although I went to my doctor immediately after finding a lump in 2014, I was sent away for almost 3 months as I was 'simply too young to have cancer.' My husband at the time was terminally ill with Huntington's disease so I stressed the importance of not missing something serious. Even with this knowledge I was continually sent away. Eventually over 10 weeks later I discovered not only did I have cancer but I had triple negative grade 3 stage 3 with lymph node spread and later told I had the BRCA1 gene—from my dad! At the time I was extremely disappointed that my GP misdiagnosed my lump. However, when I saw your campaign I realised they missed more than that. Not only did I have a lump but I had thickening of the breast and a raised vein neither of which were even mentioned in the doctor's notes." —Dawn, United Kingdom

"As a breast cancer survivor this visual is awesome. I had no idea what to look for or feel for. My tumor was on my left nipple and it had inverted. Then I had fluid leaking from my nipple. Lastly lots of pain in my breast. I was faithful getting a yearly mammogram and was a couple weeks away from that. I was unable to feel my tumor due to it being on my left nipple. The signs of it being inverted and fluid coming out are huge breast cancer red flags I knew nothing about. I am now a 6 year cancer survivor and CANCER FREE. I praise you for what you are doing to make breast cancer signs very obvious through the lemons visual." —Linda, USA

The budget for the campaign? $0. At the time it went viral, it was a nonprofit of one founded by Dr. Corrine Ellsworth-Beaumont, an American graphic designer and single mom, who got her PhD in the subject of global breast cancer communication in London. For Ellsworth-Beaumont, it was a personal matter, with two grandmothers, a dear friend and other family members who died from the disease:

"I wanted to change the way we looked at breast cancer to be easier to recognize and it is doing just that. It's changing the picture of breast cancer."

The nonprofit is now turning the 12 lemons into an app that makes it easier to spot changes, stay on top of screening and do regular self-exams with a virtual coach. The goal? Help women know what to do if that moment comes when they find a change. It's going to be a must-have for every woman's phone.

The Know Your Lemons app is expected to launch later this year. Be the first to try the app by signing up at knowyourlemons.com/app

If this campaign helped you, consider donating to Worldwide Breast Cancer. This project is entirely funded by grants and donations and you can be part of it too. Every $1 helps educate one more person.