Benign Breast Diseases: An Introduction for the Advanced Practice Nurse.

The discovery of an abnormality in the breast may provoke anxiety for patient and clinician alike. Fortunately, most lesions in the breast are benign. Physical examination and breast imaging, including mammography, ultrasound, and magnetic resonance imaging, assist in the diagnosis of benign breast diseases. Understanding benign breast diseases is important for advanced practice nurses because these diseases are commonly seen in daily clinical practice.

Evaluation of common breast complaints in primary care.

Discovery of a breast mass, nipple discharge, or breast pain is a common, anxiety-producing occurrence for many women. Although most irregularities are benign, every woman presenting with a breast complaint should be evaluated to exclude or establish a diagnosis of cancer. The patient visit to the provider for a breast complaint can also present an opportunity for the NP to address and update any needed breast screenings.

Primary care management of the female patient presenting with nipple discharge.

Nipple discharge is a common primary care finding in female patients. The nurse practitioner must possess the skills and knowledge to correctly and safely manage this clinical finding. The following is a review of the etiology of nipple discharge, the differential diagnoses, and treatment modalities.

Optimal utilization of a breast care advanced practice clinician.

BACKGROUND: Incorporation of "lean" business philosophy within health care has the goal of adding value by reducing cost and improving quality. Applying these principles to the role of Advance Practice Clinicians (APCs) is relevant because they have become essential members of the healthcare team. METHODS: An independent surgical breast care clinic directed by an APC was created with measurements of success to include the following: time to obtain an appointment, financial viability, and patient/APC/MD satisfaction. RESULTS: During the study period, there was a trend toward a decreased median time to obtain an appointment. Monthly APC charges increased from $388 to $30,800. The mean provider satisfaction score by Press Ganey was 96% for the APC and 95.8% for the surgeon. Both clinicians expressed significant satisfaction with clinic development. CONCLUSIONS: Overall, initiation of an APC breast clinic met the proposed goals of success. The use of lean philosophy demonstrates that implementation of change can result in added value in patient care.

Lactancia materna: prevención de problemas tempranos en las mamas mediante una técnica de amamantamiento eficaz / Breastfeeding problems prevention in early breast feeding through effective technique

Introducción: Actualmente la mayoría de las madres conocen la importancia de la lactancia materna tanto para la madre como para el hijo desde el punto de vista nutritivo y de desarrollo así como afectivo y de prevención de patologías; pero algunas madres desconocen que una técnica de lactancia inadecuada puede llegar a ocasionar problemas tempranos en las mamas y con ello, en numerosas ocasiones, el abandono temprano del amamantamiento. Objetivos: En este estudio se plantean las principales alteraciones mamarias puerperales que pueden estar asociadas a una técnica de lactancia ineficaz. Metodología: Se ha realizado una búsqueda bibliográfica en las siguientes bases de datos: Medline, Pubmed y The Cochrane Database of Systematic Reviews. Se incluyen los trabajos relacionados con el objetivo del presente texto. Resultados: Los estudios consultados evalúan la asociación entre la aparición de problemas mamarios y la utilización de una técnica de lactancia inadecuada y la eficacia de los tratamientos tras la aparición de las lesiones. Conclusiones: La asociación entre la aparición de problemas tempranos en las mamas asociados a una técnica de lactancia materna inadecuada es evidente. Se concluye que la prevención es el mejor tratamiento, lugar donde desarrolla una importante labor el profesional sanitario(AU)

Introduction: Currently, most mothers know the importance of breastfeeding for both the mother and the child from the nutritional point of view and emotional development as well as prevention and pathologies, but some mothers know that inadequate breastfeeding technique can cause early problems in the breasts and thus, in many cases, the early abandonment of lactation. Objective: In this study the main puerperal breast abnormalities that may be associated with ineffective breastfeeding technique, due to insufficient maternal education about it are set out. Method: We performed a literature research in the following databases: Medline, Pubmed and the Cochrane Database of Systematic Reviews. Works related to the objective of this text are included. Results: Consulted studies evaluated the association between the onset of breast problems and the use of inappropriate lactation technique and the efficacy of treatments after the onset of the lesions. Conclusions: The association between the occurrences of early problems in the breast associated with breastfeeding technique is evident. We conclude that prevention is the best treatment, where important work develops a healthcare professional(AU)

Un bulto en la mama. Tú eliges cómo abordarlo / A lump in the breast

Las estadísticas parecen indicar que en algún momento de su vida, una de cada nueve mujeres deberá afrontar un cáncer de mama. La autora relata su manera personal de hacerle frente, compartiendo las preguntas y respuestas que ha ido hallando en este camino. Es autora del libro de igual título que su artículo(AU)

The statistics seem to indicate that at some point in their lives, one in nine women must face breast cancer. The author recounts his personal way of moving forward and sharing the questions and answers that have been found in this way. She is the author of the book with the same title that his article(AU)

Benign breast disease.

This article presents an overview of the benign conditions that affect the breast for the practicing surgeon. The authors discuss the diagnosis and management of a variety of breast pathologic conditions, including those associated with infection and inflammation as well as proliferative and nonproliferative disorders. The authors also offer their experience with the integration of nurse practitioners in the care of patients with benign breast disease.

Nurse practitioner-staffed clinic at Virginia Mason improves care and lowers costs for women with benign breast conditions.

The implementation of a breast clinic based on the use of an advanced registered nurse practitioner at Virginia Mason Medical Center in Seattle, Washington, substantially improved care timeliness and efficiency for women with symptomatic benign breast conditions. Women received their final benign diagnosis in an average of four rather than sixteen days, with fewer imaging studies and physician visits, when compared to a control group. Savings to the employer were estimated at $316 per woman, primarily from increased work productivity. Direct care costs decreased an estimated 19 percent, to $213 per woman. By decreasing both direct medical costs and indirect costs such as work absenteeism and presenteeism, the Virginia Mason Breast Clinic has created substantial savings for providers and employers while delivering care that patients rate highly. This model demonstrates the feasibility of achieving higher quality at lower cost through integrated care.

Women's health: an achievable goal for public health nursing in Pakistan.

Monsoons of 2010; left devastated effects in Pakistan; it wiped away thousands of houses and damaged health infrastructure. The national and international communities rescued Internally Displaced People (IDP). Alongside the other health professionals' Public health nurses (PHN) were instrumental in assisting IDPs. This is a case study of a 30-year-old postnatal woman; who sustained an injury on her right breast and developed an abscess in IDP camp. The client was assisted by the team of public health nurses by timely referral to undergo incision and drainage for appropriate management. Moreover, post procedure follow-up assisted the woman in wound management and neonate care, especially the breast feeding. The family was also involved in client's care to ensure their empowerment in managing the case. Thus, the efforts of PHN and their health assessment saved the life of one family by saving the life of a woman in that IDP camp.

Theory of perceived access to breast health care in African American women.

The theory presented in this article proposes an alternative view of access to care on the basis of an African American woman's perception of the necessity, availability, and appropriateness of breast health care. The theory of perceived access to breast health care in African American women may also be useful in framing future research studies exploring the relationship between access to care and utilization of primary, secondary, and tertiary clinical preventive services related to breast health care.

A prospective study of fluconazole treatment for breast and nipple thrush.

BACKGROUND: Breastfeeding women with continuous burning nipple pain, often associated with post-feed radiating breast pain, may be diagnosed with nipple and breast Candida (thrush) infection. This project examined the efficacy of the three fuconazole capsule regime (one 150 mg capsule alternate days) and explored factors associated with longer courses of fluconazole. METHODS: Women diagnosed with nipple and breast Candida and treated with oral fuconazole at a tertiary hospital (n = 96) were followed up until pain resolution. RESULTS: Women took between 1 and 29 fluconazole capsules, mean = 7.3, median = 6. The number of capsules was not related to socio-demographic or health characteristics of mothers or babies; women with more severe breast pain were more likely to take > 3 capsules than women with less severe breast pain. Only minor side-effects were reported. DISCUSSION: Most women require more than three capsules of fluconazole, but two-thirds of women will require six or less.

Breast microcalcifications: how to answer women's questions.

One of your patients, a 57-year-old woman, presents to the primary care setting, clutching the results of her routine mammography screening test. She says she was told that her mammogram shows microcalcifications and that she needs further testing. She's fearful, asking you, "Does this mean I have cancer?" How do you help her interpret her mammogram results and give her guidance? A thorough understanding of the significance of pathophysiologic positive findings on routine mammograms in asymptomatic women will inform your choice of anticipatory guidance and continued care.

[Nursing care in women with breast disease: organization of a specific nurses' clinic]. / Cuidados de enfermería a la mujer con patología mamaria: organización de una consulta específica.

Breast surgery can be highly stressful for women due to the high symbolic value that it represents in bio-psycho-social terms. Before setting up a nurses' breast disease clinic, nurses felt that women were being discharged after surgery with excessive worries and doubts. The aim of this study was to describe the organization, structure, functions, and activities of the nurses' breast disease clinic in Hospital Palmós (Gerona, Spain) between 2002-2005, as well as to promote this kind of clinic. The clinic provides postsurgical care, health education, and psychological support, thus contributing to the integral care of women with this important health problem. The clinic is a resource for the follow-up of patients with breast disease. Moreover, it facilitates outpatient surgical treatment and early discharge and reduces mean length of hospital stay.

Pain at midlife.

Although menopause is a normal developmental milestone through which all women pass, the transition has been long associated with chronic pain conditions that may be more accurately viewed as secondary to aging. Clinicians need to understand management of pain problems women may experience. This article examines pain syndromes including headache, back pain, osteoarthritis, pelvic pain, vulvo-vaginal pain, and burning mouth syndrome.

[Physical breast examination]. / Badanie fizykalne gruczolu piersiowego.

The aim of the project was the comparison of the effectiveness of physical breast examination in relation to mammography on the basis of research analysis conducted within the program "The Early Diagnosis of Breast Cancer". The program was conducted at J. Sniadecki Hospital in Nowy Sacz in the year 2002. The physical examination was carried out by professional midwives. The documentation of 400 women who participated in the program was analyzed in order to gain the necessary information. Half of the participants have identified anomalies in breasts (202; 50.5%). There was no difference in the number of the mentioned anomalies between the group of the younger (55; 50.0%) and older women (147; 50.7%). One of the three anomalies diagnosed in mammography was earlier diagnosed in the physical examination. It is important to indicate that it seems more difficult to detect the anomalies in the group of younger women (13; 23.6%) than in the group of the older women (47; 32.0%). Among all anomalies diagnosed in mammography more than half (98; 53.3%) are mastopathies. Only one of the five mastopathies (19; 19.4%) was detected in physical examination. The majority of women who participated in the prevention program live in the city (244; 61.0%). Women from cities had more breast anomalies (53.3%) than women from the country (46.1%).