Conditions and Management

A nurse practitioner (NPs) is trained to assess symptoms, diagnose conditions, prescribe medications, order and interpret medical tests, and collaborate in patient care plans. These diverse medical professionals may provide primary care, acute care and urgent care services to children and adults of all ages.

A NP is a registered nurse (RN) with advanced clinical training and education. In some cases, a NP will go on to receive a master’s degree or a doctoral degree. Many NPs specialize in specific areas of care or focus on certain populations, such as pediatrics, adult medicine, geriatrics or mental health.

It takes an average of six to eight years of education and training to become a NP, according to Health eCareers. Here is a more in-depth look at education and training requirements.

Scope Of Practice

Nurse practitioners undergo extensive education and training to provide patients with comprehensive care. In 20 states throughout the U.S., NPs have full practice authority, meaning they do not have to work under the supervision of a doctor. In other states, NPs have more authority than RNs, but may require a doctor to sign off on more advanced patient care decisions.

Each state has its own laws and regulations regarding what services a nurse practitioner can deliver. Some of the most common tasks performed by NPs include basic checkups, requesting lab tests, refilling prescriptions and making treatment decisions for conditions like viruses, infections and hypertension. NPs can also refer patients to specialists.

Education & Training

Patients may encounter NPs in a wide range of settings. These medical professionals often work in hospitals, managed care organizations, office practices, clinics, community health centers, college campuses and many other locations. Before accepting a job position, NPs must provide proof of their education and training.

RN Credentials

The first step in becoming a NP is becoming a RN. There are several educational paths that can be followed to become a RN, such as enrolling in an Associate Degree in Nursing (ADN) or entering a Bachelor’s Degree in Nursing (BSN) program. Nurse practitioners may also choose to become a licensed practical nurse (LPN) before becoming a RN and eventually a NP.

Bachelor’s Degree

Enrolling in a Bachelor’s in Nursing Science degree is often the next step in a NP’s educational journey. If a nurse already has an ADN, he or she can choose to enroll in an accelerated RN-BSN program which can often be completed online. Bachelor programs in nursing typically include a clinical component where students are taught essential skills like communication, management, supervision, research and quantitative skills.

Experience

Nurses are expected to gain some level of experience after completing a bachelor’s degree program. Although this step can sometimes be skipped, it is best to have some on-the-job experience as a nurse before continuing with education.

Graduate Program

Earning a master’s degree is often the best path for nurses that already have a bachelor’s degree. A Master of Science in Nursing (MSN) is the minimum degree requirement for becoming a NP. However, some NPs may choose to enroll in a Doctor of Nursing Practice (DNP) program which is the highest level of nursing education.

Graduate nursing studies typically include both clinical training and classroom education. Master’s degrees involve 18 to 24 months of full-time study while DNP programs are a two-to-three-year educational commitment.

Licensure

Each state sets its own rules for nurse practitioner licensure; however, most facilities require proof of a national nursing certification and an advanced nursing degree. Some nurses may choose to obtain certification from a specialty nursing board, such as from the National Certification Corporation (NCC), American Nurses Credentialing Center (ANCC), the American Association of Critical-Care Nurses (AACN) or the American Academy of Nurse Practitioners Certification Board (AANPCB).

Additional Specialization

While not a requirement for becoming a NP, some health providers may pursue further education or training to specialize in a specific area or to cater to a certain population. These educational and training requirements are based on the type of specialization the person is seeking.

Receiving Care From A Nurse Practitioner

Some patients may have concerns about seeing a NP over a doctor. Although NPs typically receive less training than a doctor, they are highly qualified to handle, diagnose and treat a wide range of ailments, physical issues and diseases. Patients can count on their NP to take on many of their medical needs, such as annual checkups, vaccinations, routine screenings, and the treatment of common conditions like allergies, sore throat and the flu.

Schedule An Appointment Today With Our Nurse Practitioner

At Raleigh Gynecology & Wellness in Raleigh, NC, our team includes licensed doctors, nurse practitioners and other health professionals dedicated to assisting women with the management and treatment of GYN conditions and disorders. Contact our office today to schedule an appointment.

Part of every woman’s health care regimen should include keeping up with breast health. Women have a 1 in 8 risk of getting breast cancer. It is the most common form of cancer in women, second only to lung cancer. That is why women need to perform regular self-examinations, have annual visits to their breast care specialist, and adhere to the recommended schedule for mammograms.

Where To Start

The process usually begins when a woman or her doctor finds a change in the breast. Finding a change can begin during a self-examination, an examination by a doctor, or in a mammogram.

Self-examinations are essential for every woman once she reaches puberty. Breast cancer is a leading cause of death among young women age 15-34.

Performing monthly self-examinations will help the young woman notice changes such as a lump, a change in the texture of the breast skin, a nipple pulling inward, or a bloody discharge from the nipple. If any of those conditions are noted, a visit to the doctor or gynecologist is warranted.

Sometimes, the abnormality is unnoticed by a woman during a self-examination, yet it is detected during a routine clinical examination by a woman’s primary care doctor or gynecologist. Once the abnormality is noted, the doctor usually will order a mammogram for further evaluation.

In many cases, the developing cancer is in its early stages and is too small to be detected during a physical examination. However, a mammogram can detect the existence and location of microscopic tissue abnormalities. That is why it is crucial for women to keep up with regular mammograms once they reach the age of 40.

Once a mammogram has identified a suspicious area in the breast, more testing will be necessary to form an accurate diagnosis. That is when the patient will be referred to a breast care specialist.

Know When To See Your Breast Care Specialist

Any changes in your breasts should be looked at by your doctor. Things to watch out for include:

• A lump in or near your breast or under your arm.
• Changes in the size or shape of your breast.
• Dimpling, puckering, swelling, or bulging of the skin of a breast.
• A nipple that has changed position or is pushed inward.
• Redness, soreness, or rash on the breast.
• Unexplainable nipple discharge, especially if bloody.

These symptoms do not always mean you have cancer, but they do need to be evaluated by your doctor.

Referral To A Breast Care Specialist

Once a primary care doctor or gynecologist detects an abnormality in a breast of one of their patients, the doctor will refer the patient to a breast care specialist for a diagnosis.

What A Breast Care Specialist Does

By the time a patient is referred to a breast care specialist, the patient likely will have already had a traditional mammogram. If the patient has not had one, the breast care specialist will order one. A mammogram is a low dose X-ray examination of the breasts usually performed yearly to help detect breast cancer in its earliest stages.

3-D Mammogram

A breast care specialist may perform a high resolution 3-D mammogram. This state-of-the-art mammogram allows the doctor to view the images on a remote computer and zoom in on the suspicious areas.

Digital Breast Ultrasound

A breast ultrasound is an important device used to examine the breast using high-frequency sound waves. The sound waves create images of the internal breast tissue. The ultrasound device can usually show the doctor whether a lump is a benign fluid-filled cyst or a solid mass.

Breast MRI

A breast MRI can be used to determine the extent of cancer conditions in the breast and detect other abnormalities in the breast once they are initially detected by a mammogram, ultrasound or manual breast examination.

Biopsy

A breast care specialist may need a biopsy of the breast tissue to determine whether cancer is present and how extensive it may be. These biopsies allow the doctor to analyze the abnormal breast tissue in detail.

Genetic Testing

Some breast care specialists are able to conduct genetic testing for their patients to get information about their predisposition for cancer.

Surgery

If the breast care specialist determines breast tissue removal is appropriate, the breast care specialist may perform that surgery. Depending on the extent of the cancer, all or part of the breast tissue may be removed.

Referral to Oncologist

If the diagnosis is cancer, the breast specialist may need to refer the patient to a medical oncologist and/or a radiation oncologist for further treatment.

Contact The Expert Breast Care Specialist For More Info About Breast Health

The women’s health experts at Raleigh Gynecology and Wellness can answer any of your questions about your breast health, diagnosis or treatment. They are happy to discuss any breast health care concerns no matter what the issue may be and schedule an appointment.

A breast care specialist is a health care provider who focuses on diseases and abnormalities of the breast.

Health Care Services That a Breast Care Specialist Can Provide

Your primary care doctor or gynecologist will perform a basic physical examination of your breasts. Depending on your age, the results of your clinical breast examination, and factors like a family history of breast cancer she may refer you for a mammogram.

Those procedures are very valuable techniques for detecting diseases of the breast, particularly breast cancer, but some women have conditions that warrant more specialized breast care and treatment.

A breast care specialist can evaluate your breast health and diagnose diseases using a range of testing and state-of-the-art equipment. These tools are not always available at your general practitioner’s office.

Some of the tests a breast care specialist may perform on you that other health care providers do not usually perform include diagnostic, therapeutic, and monitoring services as described below.

Types of Diagnostic Testing

3-D Mammography

A mammogram is a low-dose X-ray examination of the breasts that is usually performed on a yearly basis to help detect breast cancer in its earliest stages. Mammograms are an effective way to detect cancer early with the goal of successfully treating and curing it.

A breast care specialist can perform a 3-D mammogram that offers patients faster and more accurate results than a traditional mammogram.

It is a state-of-the-art mammogram that converts the X-ray waves into electrical signals and transmits the image directly to your doctor’s computer. This allows the doctor to view the images remotely and manipulate them to study suspicious areas in detail.

Breast Ultrasound

A breast ultrasound is an imaging test that examines the tissues inside the breast using high-frequency sound waves. The sound waves create images of the breast tissue.

Ultrasound is often used to supplement a mammogram if more information is needed about a suspicious area of the breasts. For example, if the mammogram detects a lump, the ultrasound can advise if it is a benign fluid-filled cyst or a solid mass.

Breast MRI

If a mammogram or ultrasound shows an abnormality, your breast care specialist may perform a breast MRI. The MRI produces multiple cross-sectional images of the breast in detailed 2-D and 3-D images.

It can be used to determine the extent of cancer conditions in the breast and detect other abnormalities in the breast once they are initially seen by a mammogram, ultrasound or manual breast examination.

Some women who are at very high risk for breast cancer will qualify for routine breast MRIs as a part of high risk breast cancer screening.

Biopsy

In some cases, the doctor cannot determine from the imaging procedures whether an abnormality is cancer.

Different biopsy devices may be utilized to extract tissue samples from the breast and the surrounding area, which are then sent to a pathology lab to determine whether or not it is cancerous. These biopsy devices are minimally invasive, but they allow the doctor to analyze the abnormal breast tissue in detail.

These biopsies can be performed in the doctor’s office using local anesthesia. They are very accurate, safe and less expensive than a traditional surgical biopsy. They are performed on an outpatient basis under local anesthesia in the doctor’s office.

One device used to take a biopsy is an ultrasound-guided vacuum-assisted device to extract tissue samples. The ultrasound can locate the abnormal tissues and guide the biopsy needle toward them.

Alternatively, the doctor may perform a stereotactic breast biopsy. Rather than using ultrasound, it uses special 3-D mammography equipment to guide the biopsy needle to the suspicious biopsy site.

Another type of biopsy is a sentinel lymph node biopsy, which is performed after breast cancer has been diagnosed. A sentinel lymph node biopsy is performed on lymph node tissue to determine if breast cancer has spread outside of the breast.

Types of Therapeutic Care

A breast care specialist can render therapeutic care to treat disease in the breast. Among the therapies available include:

Localization and Excision of Lesions

A breast lesion is an abnormality in the breast tissue that usually manifests itself as a lump, swelling or calcifications. They are frequently found through a physical breast exam, mammogram, ultrasound or MRI.

Most breast lesions are benign, but a breast care specialist should be consulted if a lesion is detected. It is not unusual to remove suspicious lesions surgically.

Treatment of Nipple Discharge and Bleeding

Nipple discharge can be a sign of a problem that needs treatment. Discharge can be caused by many different conditions, such as pregnancy, infection, hormone imbalance, breast cancer, injury, fibroadenomas, papilloma, cysts, and other diseases.

Any time a woman has nipple discharge, it needs to be evaluated by a doctor, particularly if blood is in the discharge, or if only one of the breasts is affected.

Mastectomy

A mastectomy is a surgical procedure that removes the entire breast. It is one of the most effective treatment options for breast cancer because it removes all of the cancerous tissue.

A mastectomy can be performed in such a way that it preserves the skin or the nipple to allow for a more natural appearance after reconstruction of the breast.

Oncoplastic Surgery

Oncoplastic surgery of the breast employs new technology that provides effective medical and cosmetic results for breast cancer patients.

It can avoid the patient needing additional reconstructive procedures. This procedure often allows the patient to maintain and sometimes improve the shape and appearance of the breast following surgery.

Contact the Breast Care Specialists at Raleigh Gynecology and Wellness for More Information

The breast care specialists at Raleigh Gynecology and Wellness are ready to help you with any concerns you have about your breast health. Contact them today to schedule an appointment.

According to the World Health Organization, over 2 million women are affected by breast cancer each year. Breast cancer is the most common cancer among all women. Early detection improves the odds of successfully treating breast cancer. Regular breast examinations, mammograms, and seeing a breast care specialist are the best ways to detect breast cancer at an early stage.

When Should You See Your Doctor About Breast Care?

A breast examination will involve a physical exam by your doctor. The breast examination is often done as part of your regular gynecological examination. Once you become sexually active or reach age 21, whichever occurs first, you should receive yearly wellness examinations.

The risk of women in their twenties developing breast cancer is low. Only about one in 2,000 women in their twenties get breast cancer.,

The chances of developing breast cancer increase as you age. Women in their thirties have a 1 in 229 chance of getting it. It increases in your forties and fifties to 1 in 37. By the time you reach your sixties, your chances increase to 1in 20.

How often you should have a breast examination depends on your age and medical history. Below is some general advice on the frequency of seeing your doctor for breast examination:

Whenever You Notice Changes in Your Breasts During a Self-Examination

Any sudden changes in your breast tissue could be a sign of something serious. Specifically, you should be on the lookout for changes in size, any lumps, nipple inversion (meaning it appears to be sucking inward instead of poking outward), redness, dimpling, puckering or scaliness of the skin of your breasts, or any unusual nipple discharge or secretion, especially a bloody discharge. If you notice any of those conditions, you need to have a professional breast care specialist examine you.

The National Breast Cancer Foundation recommends that all women learn how to perform a self-examination of their breasts and conduct one every month.

The best time to do a self-examination is seven to ten days after your menstrual period starts. On those days, your breasts are less tender and swollen. If you have reached menopause, you should try to do your self-examination on the same day every month.

Annually After Age 40 Until Age 75

Once you reach age 40 and until you are 75, you should begin seeing your doctor for a breast examination every year. The risk of developing breast cancer increases with age.

Also, if you have a family history of breast cancer, your doctor may recommend that you have a clinical breast examination more often. Your doctor will perform a physical exam and then schedule you for a screening mammography to detect abnormalities in your breast tissue. Regular mammograms reduce the breast cancer mortality rate by 20%.

As Recommended by Your Doctor

Women over age 75 may no longer need annual mammograms because their risks profiles change as they age.

On the other hand, women who are at increased risk for cancer because they have a family history of it, have themselves had cancer or have had abnormal findings in their mammograms, or have a higher risk because they carry a specific genetic mutation may need more frequent examinations.

Types of Testing for Breast Health

Your doctor will perform a manual examination of your breasts. In addition to physical examinations, you may need more careful examination of your breasts.

Mammography

Your doctor will likely order a mammogram for you if your doctor notices any abnormality during the physical examination or if you are between age 40 and 75. A mammogram is a low-dose X-ray of your breasts.

During the mammogram, a special x-ray machine will compress your breast tissues between two firm surfaces to photograph the tissues.

A specialist will study the photographs for abnormalities such as tumors and lumps. This test can detect signs of cancer in women before the symptoms become detectable during a physical examination.

Ultrasound

If the mammogram shows abnormalities, an ultrasound of the area of concern may be needed. An ultrasound can reveal the size and shape of any lumps and allow the doctor to determine if it is a benign cyst, normal tissue or a potentially cancerous tumor. Ultrasounds are also used to monitor previously identified abnormalities.

MRI

Magnetic resonance imaging, or MRI, uses radio waves and magnets to create detailed images of breast tissue. It is sometimes useful to diagnose breast cancer and to assess known tumors. MRI can also be used for breast cancer screening in women who are at very high risk for cancer.

Biopsy

If the other tests indicate that you might have breast cancer, your doctor will likely order a biopsy of the affected breast tissue. In some cases, a biopsy is the only way your doctor can know with certainty that a mass cancerous, and what type of cancer it is.

During a biopsy, your doctor will use a needle to remove small pieces of tissue from the suspicious area and a pathologist will examine it in the lab for cancer cells.

Contact The Breast Care Specialists At Raleigh Gynecology And Wellness

The women’s health experts at Raleigh Gynecology and Wellness can answer your questions about breast health and provide you with top quality care. Contact them to schedule an appointment for your examination.

A healthy breast care routine should start with regular self-examinations. Self-examinations are not a substitute for regular visits to your doctor or appropriately scheduled mammograms.

However, keeping up with self-examinations will make you better able to notice changes in your breasts between your doctor visits.

Many changes in your breasts are normal, while other changes warrant a visit to your doctor. How can you tell the difference?

Importance of Self-Examinations

With regular self-examinations, you are more likely to notice changes in your breasts when the changes first appear. The growth of cancer can cause some changes in your breasts.

As cancer progresses, it grows and pushes normal breast tissues out of its way, resulting which may result in changes in the shape of your breasts, your breast skin texture, or the appearance of your nipples.

Performing regular self-examinations can increase your chances of detecting cancer at an early stage in its development. Early detection is key to successful treatment before it has a chance to become a life-threatening condition.

If you notice any abnormalities in your breasts during your self-examination, you should make an appointment with your doctor as soon as you can. Your doctor will examine you and may schedule you for a mammogram to determine if the abnormality is something that warrants further testing.

How to Perform a Self-Examination of Your Breasts

The best time to perform a self-exam is the week after the end of your period. Your hormone levels are more stable right after your menstrual cycle, and the cyclical tenderness and swelling have disappeared.

Position yourself in front of a mirror with bare breasts. Conduct a visual examination of your breasts with your arms raised overhead and then with your hands pressed on your hips. Note any puckering, dimpling, changes in size, shape or symmetry, or nipples appearing to be pushing inward rather than pushing out in front.

After the visual inspection, lie down on a flat surface. Using the pads of your middle three fingers (not your fingertips), feel the tissue closest to the skin by applying light pressure.

Then use medium pressure to feel a little deeper and firmer pressure to feel the tissue closest to the chest and ribs. Move your fingers to another spot on your breast and repeat the process. Move around your breast methodically as you examine your entire breast and your nipples.

Common Signs of Cancer in the Breasts

Below are some of the most common signs of cancer, especially if they occur in only one breast:

Changes in Nipples or the Skin of Your Breasts — Dimpling, Pain or Nipple Discharge

Sudden changes in the shape, size and color of your nipples after you reach puberty are not normal.

Any changes in the appearance of your nipples such as inversion or retraction– meaning that one or both of your nipples has taken on a sucking-in or pushed-in appearance– and certainly a discharge from one of your nipples that is new or unexplainable, are all reasons to seek a medical examination.

A discharge is not always a symptom of cancer but any abnormal discharge, especially a bloody discharge, should be checked by your doctor nonetheless.

Likewise, you should see your doctor if you notice any changes in the skin of your breasts. Symptoms such as persistent redness, an itchy or scaly rash, dimpling, puckering, ridges, or other changes in the skin on or around the nipple warrant an examination by your doctor.

Hard Lump or Knot on the Breast or Underarm

Most women know that one of the telltale signs of possible cancer is a hard lump on either breast or in the area under either of your arms. A lump, even a tiny lump, is reason to schedule an appointment with your doctor as soon as possible.

Lumps may be a benign cyst, or it can be a cancerous mass, and knowing which is crucial. An abnormal lump will feel different from the natural lumpy feel of your breast tissues and glands. Dangerous lumps will often feel hard and they often have irregular edges.

Some cancerous lumps are painful to the touch but are rounded or have a softer feeling. Thus, it is imperative that your doctor examine any new lump.

Swelling, Warmth and Redness

A hard lump is not the only sign to watch out for. Another symptom of breast cancer is irregular swelling, warmth, and redness of your breast.

Swelling and redness can be a symptom of a rare form of inflammatory breast cancer. With inflammatory breast cancer, the skin of your breast can appear pink, purple or even bruised.

Breast tenderness and swelling during menstruation is normal. What is not normal is persistent tenderness and swelling accompanied by discoloration or redness that lasts longer than one week. The abnormal swelling could be due to the cancer irritating or blocking normal breast function.

Contact Raleigh Gynecology and Wellness for More Info On Breast Care Routine

If you have any questions about the signs of breast cancer and what to do if you notice any of them, contact the specialists at Raleigh Gynecology. They can discuss your symptoms and schedule an appointment for a full examination.