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    The mission of the Breast Cancer & Women's Health Institute of Central Pennsylvania is to provide exceptional and compassionate care to women facing breast cancer. It is our goal to make a positive impact on breast health issues and provide guidance to help EMPOWER women to obtain their optimal state of health. We believe that our patients are the center of the health care team.


    We recognize that each woman is unique and that is the approach we take with each woman's plan of care. Our top priority is to provide personalized attention, ally fears, rabidly diagnose, and stage breast cancer. We believe in EMPOWERING women with the knowledge they need to make the right decision regarding care.


    The Breast Cancer and Women’s Health Institute of Central Pennsylvania provides a variety of services to support breast health. Services include:

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    David Arbutina, M.D., FACS

    David Arbutina, M.D., FACSDavid Arbutina, M.D., FACS, serves as medical director of the Breast Cancer & Woman's Health Institute of Central Pennsylvania. Dr. Arbutina is a board certified general surgeon with focused expertise in breast cancer surgery. He is an expert, educator, and leader in surgery who since 1988 has dedicated his career to the treatment of breast cancer. During his career, Dr. Arbutina has personally treated and cared for well over 1,000 breast cancer patients. He has also treated thousands of women with benign breast conditions and is known for his expertise is distinguishing between benign and cancerous breast disease.

    Latest Blog Entries

    You cannot be empowered without knowledge.  You cannot make an informed consent if you don’t have all the information.  It is almost impossible to understand anything  when you have just been told you have breast cancer!  Add to this the complicated manner in which breast cancers are classified and it is indeed difficult to be empowered. 

    So what does it take to help you get through this most difficult encounter?  The most important ingredient is time.  It takes time to allay fears and time to present all the details to educate you so you are well informed about your disease.  Time to explain what options are available for therapy and the results expected for the different options.  In a rushed situation you are given a list of statistics and are told what treatment is best depending on how you fit into a “clinical model.”  Often, there is little understanding occurring and blind acceptance because the statistics are overwhelming and frequently misleading.  The bottom line is, don’t be pegged as a statistic and give up one of the most important decisions of your life!   Find a provider willing to take the time to evaluate and explain your unique situation.  Don’t feel rushed into a therapy that you don’t feel comfortable about.  Get empowered with the knowledge to take charge of your own care.

    At the Breast Cancer and Women’s Health Institute the goal is to empower you in your time of need.  We aim to get you in for your initial appointment for breast cancer promptly.  At this appointment we begin with an overview of your situation to quickly clear the fears of the unknown.   We then gather a detailed history and perform a careful physical exam to see what will be needed to treat your cancer properly.  You are not a statistic.  You are not a number to be placed on a protocol or a standard therapy which may not be what you would desire if you knew all the facts.  You need to know what you are facing and the choices available to deal with the problem.

    I have had women come in confused about their breast cancer.  They are told they need chemotherapy because the surgery “didn’t get it all.”  This statement is often misleading because in the majority of patients, treatment of the breast alone does “get it all.”  However, since there is no way of knowing for certain whether there are any cancer cells still in your body, you are told you need a therapy because there is a chance you may have some cancer remaining.  To be empowered you need to know this fact before you decide on a therapy.

    Also, you must accept that not every therapy works.   I’ve asked patients with incurable cancers why they are taking a particular therapy and they reply, “to cure the cancer of course.”  There could not be anything further from the truth, however; because of this misunderstanding, they willingly accept a therapy which may statistically help 20% of recipients but cure none.  It may improve their quality of life in some cases but is not a cure.

    Empowerment is our goal.  When you understand your disease, especially something as serious as breast cancer, you’re ready to decide what is best for you.  There will always be an element of the unknown because science cannot detect small clusters of cancer cells which may be present in your body.  When you develop an understanding of the statistics, it will allow you to make an educated decision about your risks.  Be empowered!  Don’t delegate this most important decision about your health to others.  Get empowered, take control and prepare to make the tough decisions about breast cancer. 


     By: Dr. David Arbutina, The Breast Cancer & Women’s Health Institute of Central PA

    Genetics of Breast Cancer

    Family history or genetics are among the risk factors for breast cancer.

    According to the National Cancer Institiute of the National Institutes of Health (NIH), an estimated 5% to 10% of breast cancers are thought to be inherited making some women genetically predisposed to developing breast cancer.  What is inherited is the increased risk of getting breast cancer, not the disease itself.

    The average woman in the United States has a  12%-13% chance of developing breast cancer. Women who are genetically predisposed have an 80% chance of developing the disease.

    We all have hundreds of thousands of genes in our body. Each gene has a specific job to do.  Genes determine everything from the color of our hair to how each cell of the body functions.  If an abnormality develops in the genes that are associated with breast health it increases breast cancer risk.  For most women who develop breast cancer, environmental or lifestyle factors cause the genetic abnormality sometime during their lifetime. Women who inherit or are genetically predisposed are born with the abnormality in their genes.   

    Researchers have identified specific genes that are associated with breast cancer. BRCA1 and BRCA2 are major genes related to inherited breast cancer risk.  The ATM and CHEK2 genes are also thought to be involved.  Research suggests that CDH1, STK11, TP53, AR, BARD1, BRIP1, DIRAS3, ERBB2, NBN, PALB2, RAD50, and RAD51 may also play a role.

    Genetic testing, a special blood test,  is used to determine if you are gentically predisposed to breast cancer.  Your physician will determine the need for genetic testing. This decision is generally based on your individual and family history and the nature of the tumor and age of the patient who develops breast cancer.  

    Circumstances that suggest a woman may be genetically predisposed to breast cancer include:

    • Blood relatives on either side of the family who had breast cancer before age 50.
    • Family history of both breast and ovarian cancer, particularly in a single individual.
    • Family history of other cancers and/or onset at a young age.
    • Female relatives who have had cancer in both breasts.
    • Ancestry that is Ashkenazi Jewish (central or eastern European) Norwegian, Icelandic, Dutch or African American and diagnosed with breast cancer at age 35 or younger.
    • Male breast cancer in your family.
    • Multiple cancers within a family or rare cancers.
    • Cancers in multiple generations of a family.
    • Rare cancers associated with birth defects.

    It is important to know if you are genetically predisposed to breast cancer. If you are getting the test because you are diagnosed with breast cancer and are positive then you need bilateral mastectomies to prevent recurrence. If you get the test because a family member has the gene and you too have the gene then generally, your risk of breast cancer is extremely high.  Bilateral mastectomy is the only prevention.  To wait until you get breast cancer  before you act is not advisable because at that point you may die from the disease.

    Protective (prophylactic) surgery is the best alternative for indidivuals with the breast cancer gene. This involves removal of both breasts and today is often performed with immediate reconstruction. This is an aggressive step that requires careful thought and discussion with your physician. Protective breast surgery is not a 100% guarantee but it is able to reduce a woman\'s breast cancer risk  by as much as 97%.  There is also a 35% risk of ovarian cancer so if the patient is beyond child bearing age removal of the ovaries is encouraged.

    Remember, most women are not genetically predisposed to breast cancer.  However, it is important to know if you are in that small group of women who at high risk because of your genetics. Talk to your doctor about your unique breast health circumstances and follow your physician’s recommendations to reduce your breast cancer risk.  

    To reach the Breast Cancer & Women’s Health Institute of Central Pennsylvania call (814) 470-7732.


    The United States Healthcare systems, from solo practice physicians to large medical centers or health care organizations, are now in competition to gain access to patients because they represent dollars.

    Unfortunately, advertising about health care is here as a result. But do the ads really help you choose where to go? Does a catchy jingle or a logo really mean goodhealthcare? Is good healthcare provided by a new building or a healthcare insurance plan? No, the jingle and logo mean a good advertising department and the building and plan signify a team of administrators. Good health care comes from good doctors who surround themselves with good staff. The doctor on the billboard or TV commercial may look good, but who is that doctor? Do you want to put your life in their hands because they made a commercial?  Bottom line is, know your doctor!

    David R. Arbutina, MD, FACS a distinguished graduate of the United States Air Force Academy and a member of the Alpha Omega Alpha medical honor society. He is an expert, educator and leader in surgery who since 1988 has dedicated his career to the treatment of breast cancer.

    As an expert, Dr. Arbutina has cared for well over 1,000 breast cancer patients. He has also treated thousands of women with benign breast conditions and has the expertise to distinguish between the two.  He has personally been the lead investigator in breast cancer research protocols.  He has been an advocate for surgical education. Then, Colonel Arbutina, was the director of one of four general surgery residencies in the United States Air Force. He was in charge of the program for 10 years and was personally responsible for training over 50 Air Force surgeons who through his guidance now practice in many different surgical fields. He continues to maintain his academic appointment at the Uniformed Services University of Health Sciences at Bethesda.  As a leader, he was the chief consultant to the Air Force Surgeon General in general surgery and was responsible for surgical assignments around the world. He is a past President of the Society of Air Force Clinical Surgeons and was also awarded that society’s Excalibur Award.

    Today, Dr. Arbutina is the current President of the Keystone Chapter of the American College of Surgeons where over the past 5 years he has personally directed 2 educational programs for the regions surgeons. Finally, he is a governor of the American College of Surgeons, and as such, helps forge policies to promote safe and economical surgical care across the nation.

    Do not rely on logos, TV commercials or billboards as a guide to your health needs. If you have a breast problem, contact an expert with a record of excellence in the field. Do your homework and know your surgeon.

    If you have a breast problem Dr. David Arbutina, the Director of the Breast Cancer Institute of Central Pennsylvania, would be honored to help you through your trying times. For an appointment call (814) 470-7732.

    David Arbutina, MD, FACS is a governor of the American College of Surgeons and the current President of its Keystone Chapter. His surgical practice has been focused on breast cancer since 1988 and he has been involved in research and education about this topic for 24 years.

    The most current research indicates that five percent of breast cancers occur in women under age 40.  Even though Breast Cancer in young woman is rare, it is still important to educate young women on breast health.  Talking to your daughter about breast cancer can be a difficult conversation.  Women can be taught about breast health at an early age.  Topics of breast health can include:

    1. Eating a healthy well-balanced low fat diet.   Researchers from the University of California at Davis found that a diet linked to obesity and harmful metabolic changes stimulated early breast growth and led to abnormal tissues in the breast that may produce breast cancer.

    2. Speak candidly to your daughter about checking their breasts.  When speaking to your daughter reassure her that breast cancer in young women is rare; however it is good practice to learn about breast health at a young age.  By age 20 women should begin having clinical breast exams, at least every three years then every year after the age of 40.  Self breast exams should be done on a monthly basis beginning in puberty.  Listening to breast health education and awareness may decrease the fear your daughter may have about breast cancer.

    3. Know your daughter’s risks of breast cancer: age and family history.  If a family history of breast cancer exists, inform your daughter’s primary care physician.  This will permit the physician to discuss the risk factors and prevention measures with your daughter.  Teenagers learn by example.  Moms can teach their daughters about self breast exams by demonstration.  Having conversations about the importance of screenings and self breast exams will increase breast health awareness. Reassure your daughter that if she discovers a lump, it does not mean she has breast cancer.  There are many normal changes that take place in breasts as women age as well as throughout the menstrual cycle. 

    There are certain guidelines to follow when determining if a physician should be consulted.  If your daughter experiences any of the following symptoms, call her doctor:

    1. a hard knot or lump near her underarm
    2. changes in color, size, shape or texture
    3. dimples, puckers, bulges or ridges on the skin of your breast
    4. an inverted nipple
    5. redness, warmth, swelling or pain
    6. itching, scales, sores or rashes
    7. a clear or bloody nipple discharge

    Teaching your daughter about making healthy lifestyle choices may help reduce breast cancer risk.  Healthy lifestyle choices include: maintaining a healthy weight, regular exercise, avoiding alcohol intake, and not smoking.  Practicing healthy lifestyle behaviors will not only decrease the chances that breast cancer will occur, they can lower your risk of other serious illnesses!

    If you have a breast problem the Breast Cancer & Women’s Health Institute of Central Pennsylvania, would be honored to help you through your trying times.  For an appointment call (814) 470-7732.

    David Arbutina, MD, FACS is a governor of the American College of Surgeons and the current President of its Keystone Chapter. His surgical practice has been focused on breast cancer since 1988 and he has been involved in research and education about this topic for 24 years.

    Breast pain is relatively common and experienced by an estimated 50% to 70% of women. In medical terms breast pain is referred to as mastodynia, mastalgia or mammalgia.

    Women with breast pain often fear it is a symptom of breast cancer. In fact, it is rarely a sign of breast cancer and only a small percentage of women with breast cancer experience breast pain as a symptom.

    Breast pain can occur in women of all ages and can range from mild tenderness, tingling or discomfort to severe pain.  It can be present in one or both breasts and has many causes.

    Causes of breast pain may include hormonal changes, cysts, trauma, breast surgery, certain medications, infertility treatment, breast size, water retention, an infection in the breast, stress, breast feeding, Page Closingpregnancy, going on or off of hormone replacement therapy or birth control pills or from an ill fitting bra.  Since there are so many potential causes of breast pain, it can be challenging to diagnose.

    Generally, breast pain is categorized as either cyclical or noncyclical.

    Cyclical breast pain is most common. It is associated with a woman’s menstrual cycle.  This type of breast pain usually affects both breasts. It is described as dull, heavy or aching and is often accompanied by breast swelling or lumpiness.  Noncyclical breast pain is less common. It is unrelated to the menstrual cycle and usually occurs in postmenopausal women. This type of breast pain is often described as a tight, burning or sore sensation that is persistent. Typically it is localized to one breast.   Noncyclical breast pain may come from somewhere else, such as the muscles or joints and radiate to the breast. Causes of noncyclical breast pain may include trauma to the breast or arthritic pain in the chest cavity or neighboring areas.

    Pain is a warning signal that something in the body is awry and should not be ignored.  Women are advised to consult with their physician if any of these symptoms occur.

    (1) If their breast pain does not go away at the end of their menstrual cycle.

    (2) If they experience any breast pain that lasts for more than a couple of weeks or if the pain worsens. 

    (3) If pain is localized to a specific area of the breast. 

    (4) If the pain interferes with daily activities.

    Treatment for breast pain can vary from addressing infection or cysts to simple lifestyle modifications such as wearing a proper fitting bra, avoiding caffeine, using over the counter or prescribed medications, stress reduction and dietary modifications to name a few.  

    Don’t ignore breast pain. Consult with your physician and follow your physician’s recommendations.

    To reach the Breast Cancer & Women’s Health Institute of Central Pennsylvania call (814) 470-7732.