Review of vocabulary in all units
To make tangible some of the information that students have learned about breast lumps and the importance of mammograms, clinical breast exams, and breast self-exams. To create opportunities through the wearing of the necklace for students to talk about these issues with family and friends. To create a relaxing atmosphere in the classroom for personal story sharing.
1. The teacher should make a Beads for Life necklace and wear it to class.
2. To introduce the lesson, call attention to the necklace and ask if anyone has noticed it.
3. Explain what the beads represent:
The smallest bead is the size of a breast lump that can be found if a woman has a mammogram every year. If this lump is cancerous, she has the best chance at this point of saving her life and her breast. Hold the bead to your breast to show how small it would be.
The largest bead is the size lump that could be found if a woman rarely checks her breasts and never has mammograms. At this stage, her chances of survival are not as good.
4. Invite students to make their own necklaces. Pass out the beads and paper plates. Suggest that a temporary knot be made at the end of the cord to prevent the beads from slipping off. Refer to the completed necklace as a model for how to string the beads.
5 Pull out the Beads for Life Journal Page. While handling the beads, encourage discussion about the bead sizes and the importance of regular mammograms. When students have strung all their beads, tie the ends together.
6 Focus attention on the Beads for Life Journal Page and discuss how students might use it to explain the beads to family members or friends. Men in the class can be encouraged to present these necklaces as gifts to the important women in their lives.
7. Have one student role play explaining the meaning of the beads with the teacher or have students role play with each other. This is in preparation for sharing the meaning of the necklaces with a family member or friend.
Students can explain their bead necklaces to an older female family member (age 50 or older) or to an older woman friend. If enough beads are available, students can take some to make a necklace with this friend and explain what each bead means. In addition, if enough beads are available, you can team up with another class in your learning center. Each of your students can partner with another student and "teach" them the Beads for Life by doing the activity together.
Using the Reflection: Beads for Life Journal Page ask learners to write a personal reaction to this activity. Writing prompt questions such as the ones listed below may help learners generate their written responses.
What did you learn by making a Beads for Life necklace?
How did you feel making this necklace?
How do you feel wearing it?
Who would you like to share this Beads for Life necklace with? Why?

The different sizes of the beads in this hands-on activity lend themselves easily to a grammar lesson on comparatives and superlatives. The activity gives a powerful context for understanding what "smallest vs. biggest" may mean. And, how a person can play an active role in identifying a "smaller vs. bigger" lump.
This lesson was adapted from work done by Marilyn Swan for the Kentucky Department of Public Health Breast and Cervical Cancer Control Project in 1998. Based on an idea from Skinner, C.S., et al. "Learn, Share, and Live: Breast Cancer Education for Older, Urban, Minority Women." Health Behavior and Education, 1998, 25 (1): pg. 60-78.