Venue of Workshop:

Date: / / . Day: Time:

PRE-WORKSHOP ASSESSMENT
An assessment of awareness regarding BREAST CANCER and its early
detection among Indian Women

Please encircle/fill the appropriate response(s). Wherever required you may choose
more than one response.

1 Age (in completed years)

2 City

3 Religion
a) Hindu b) Muslim c) Sikh d) Christian e) Other a b c d e

4 Marital Status
a) Married b) Unmarried c) Divorced d) Widow a b c d

5 Educational Status

6 Occupation

7 Breast cancer is the leading cause of cancer

deaths among women in metropolitan cities
a) True b) False a b

8 Chances of being diagnosed with breast cancer

increases with age
a) True b) False a b

9 How does one recognize (signs / symptoms) of

the disease?
a) Lump in breast b) Discharge from nipple
c) Skin of the breast shows changes d) Shape
of the breast/nipple changes e) Pain in breast
a b c d e

10 Which of these increases the risk of developing

breast cancer?
a) Family history b) Late age at first pregnancy
c) Early onset of menstruation d) Obesity
e) Multiple sexual partners
a b c d e
11 Does breast feeding protect against breast
cancer?
a) Yes b) No a b

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12 How can breast cancer be detected early?

a) Breast self examination b) Clinical
examination by a doctor c) Mammography
d) Any other
a b c d
13 Are you aware of a technique called Breast Self
Examination (BSE)?
a) Yes b) No a b

14 Have you ever examined your breasts using the

technique of Breast Self Examination?
a) Yes b) No a b

15 At what age should one begin to perform BSE?

a) After 50 years b) After 40 years c) After 30
years d) After 20 years
a b c d
16 When should one do BSE?
a) During menstruation / periods b) Before
periods c) End of periods d) Anytime during the
month e) Don't know
a b c d e
17 How frequently should BSE be done?
a) Daily b) Monthly c) Yearly d) Whenever
convenient e) Don't know
a b c d e
18 Which is the best position to feel your breasts
for lumps?
a) Standing b) Lying down c) Sitting a b c

19 Most of the breast lumps are first detected by

the women themselves.
a) True b) False a b

20 Most of the lumps detected in breasts are due to

cancer.
a) True b) False a b

Swaasthya Sanchar, D7/7412, Vasant Kunj, New Delhi – 110070, Page 2 of 2

Tel: 97 170 55 33 2, Email: khanzh@swasthyasanchar.org, visit us at www.swasthyasanchar.org