The Kathryn Candor Lundy Breast Health Center is the most comprehensive breast health center in the region, providing patients with a complete range of breast health service all located in a single, attractive and comfortable location. The Center also brings together a team of specialists that include nationally recognized breast surgeons, breast health nurse specialists, certified mammographers, ultrasonagraphers, radiologists and pathologists who are all committed to providing leading-edge technology and compassionate care to give our patients peace of mind. We are located in Suite 303, 1705 Warren Ave. Williamsport, PA 570-326-8200.

The Change in Recommendations for Mammogram From A Local Breast Surgeon’s Perspective Timothy J. Pagana, MD, FACS, Medical Director of Susquehanna Health’s Kathryn Candor Lundy Breast Health Center offers Susquehanna Health’s perspective on the changes in recommendation for mammography and breast self-exam.

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Bisphosphonates - What's all the Hype?

by Timothy J. Pagana, MD, FACS

Bisphosphonates are medications designed to decrease the risk of bone fracture in postmenopausal women. Fosamax (generic = alendronate), Actonel (risedronate), or Boniva (generic = ibandronate) are the most commonly used examples of pill forms of bisphosphonates. Reclast (generic = zoledronic acid) is an intravenous form of bisphosphonate. For years, some women have hesitated to take this medication, when recommended by their doctor, because of the fear of prolonged jaw infections following dental surgery. While the actual numbers of women who experience this complication are miniscule women are still understandably hesitant. There have been some recent reports in the media and on the internet suggesting that taking bisphosphonates places the user at a high risk for developing an unusual type of hip fracture. This month, the FDA has concluded these unusual hip fractures are no more common among bisphosphonate users than women who don't take a bisphosphonate medication.

Now there are more reports about bisphosphonates and this time, it isn't all bad. Two separate studies that have recently been completed suggest that using an orally administered bisphosphonate medication will decrease the chance of developing breast cancer. Again, like the "case report" type of studies indicating jaw and hip problems with bisphosphonates, the breast cancer reduction studies suffer from inaccuracies and hyperbole. These most recent studies are "observational" studies that lack the statistical power to truly indicate that bisphosphonates decrease the chance of getting breast cancer. There were too many confounding factors in these studies that may make their conclusions wrong. For instance, it is possible that the group of women who took bisphosphonates experienced a reduced number of breast cancers because of factors other than the bisphosphonates (e.g., lower estrogen levels, better genetic factors, etc). Most doctors prefer the statistically more powerful "randomized" studies where half the women get a bisphosphonate pill and the other half do not…then see which group has what effect - good or bad.

Breast cancer and bone fractures from reduced bone density are two very common diseases that affect post menopausal women in the western world. Women, as expected, are very concerned about the risks and benefits of taking medications designed to reduce their chances of experiences of either of those diseases. When considering the cost, side effects and potential harm of taking bisphosphonates, women will want to be sure the medication will accomplish its intended purpose. Your doctor watches the literature carefully to find these studies, interprets their validity, and will discuss whether or not taking a bisphosphonate (or any medication) is right for you.

Timothy J. Pagana, MD, FACS is the Medical Director of Susquehanna Health's Kathryn Candor Lundy Breast Health Center located at 1705 Warren Avenue, Suite 303 in Williamsport, Pennsylvania. He also serves as the Medical Director of Divine Providence Hospital's Surgi Center. Dr. Pagana graduated from Temple University School of Medicine and completed his Residency at Episcopal Temple Hospital in Pennsylvania. In addition, he completed a Fellowship at Roswell Park Memorial Institute in New York. He is Board Certified in Surgery.