Breast examination should be performed in a female patient
A. At the onset of menstruation B. During ovulation C. Aduth menstruation D. During menstruation
Correct Answer: C. Aduth menstruation
Explanation
Breast examination should be performed in a female patient regularly and at specific recommended times to help detect any abnormal changes early.
Breast Examination Includes:
- Breast Self-Examination (BSE)
- Should be done once every month
- Best time is 7–10 days after the start of menstruation when breasts are least tender and swollen
- For women who are menopausal or have irregular periods / hysterectomy, choose a fixed day every month (e.g., 1st of each month)
- Done in front of a mirror, while lying down, and during shower
- Clinical Breast Examination (CBE)
- Performed by a doctor or nurse
- Recommended every 3 years for women aged 20–39 years
- Yearly for women 40 years and above
- Mammography
- Screening recommended once a year after 40 years (or earlier if high-risk family history)
Steps of Breast Self-Examination
✔ Look (inspection in front of mirror)
✔ Feel (palpation using fingers) in circular, wedge, or vertical pattern
✔ Check for:
- Lumps or thickening
- Nipple discharge or inversion
- Changes in size or shape
- Skin changes (dimpling, redness, puckering)
Key Points
- Use opposite hand to check the breast (right hand for left breast and vice-versa)
- Do not use soap or lotion while palpating because it may slip and hide lumps
- Perform in multiple positions: Standing, lying, and raising arms
Conclusion
Breast examination should be performed monthly by the woman herself, regularly in clinical check-ups, and with mammography after 40 years for early detection of breast cancer.
Other Options Details
Here is the explanation for each option:
A. At the onset of menstruation
- This refers to the beginning of the menstrual cycle when bleeding just starts.
- Hormonal levels of estrogen and progesterone drop suddenly, causing shedding of the endometrial lining.
- Many symptoms like cramps, mood changes, and fatigue may occur at this time.
B. During ovulation
- Ovulation occurs around the 14th day of a 28-day cycle (mid-cycle).
- The ovary releases a mature ovum (egg).
- Estrogen levels are high and LH surge triggers ovulation.
- Some women may feel mild lower abdominal pain called mittelschmerz.
C. Aduth (next) menstruation
- This refers to the upcoming menstrual cycle or the next period.
- After ovulation, if fertilization does not happen, progesterone and estrogen decline.
- The uterine lining prepares to shed again.
D. During menstruation
- This is the time when bleeding actually occurs, lasting about 3–7 days.
- The endometrium breaks down and exits the body through the vagina.
- Prostaglandin release may cause cramps, backache, and discomfort.
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Writer: Vandita Singh, Lucknow (GS India Nursing Group)