Lactating women with painful breast, 1st investigation to be done should be NOT RELATED-SURGERY
**Core Concept**
The management of painful breast in lactating women requires a thorough evaluation to rule out underlying conditions that may require prompt treatment. The first investigation should aim to identify any potential causes such as mastitis, abscess, or ductal ectasia.
**Why the Correct Answer is Right**
The correct answer is a clinical examination to assess for signs of inflammation, such as redness, swelling, and warmth. This is followed by a thorough breast examination to evaluate for any palpable masses or tenderness. A clinical examination is essential to identify any abnormalities that may require prompt medical attention, such as mastitis or abscess.
**Why Each Wrong Option is Incorrect**
**Option A:** Imaging studies such as mammography or ultrasound may be useful in certain cases but are not the first-line investigation in lactating women with painful breast.
**Option B:** Blood cultures are not typically the first investigation for painful breast in lactating women, as mastitis is usually caused by Staphylococcus aureus, which is not typically identified through blood cultures.
**Option C:** Fine-needle aspiration cytology (FNAC) may be useful in evaluating breast lesions, but it is not the first investigation for painful breast in lactating women.
**Clinical Pearl / High-Yield Fact**
It is essential to note that lactating women with signs of mastitis or abscess should be treated promptly with antibiotics and may require hospitalization for intravenous antibiotics and drainage of the abscess.
**Correct Answer: D. Clinical examination.