Call (334) 747-7440 to make an appointment.
No doctor referral necessary.
At the UAB Breast Health Clinic, part of the UAB Medicine Multispecialty Clinic at Baptist Medical Center South, we are dedicated to providing the highest quality service and care to the women of Central Alabama. Here, we focus on personalized care, easing fears and explaining every step in the breast surgery process to bring you peace of mind, while also providing compassionate care in an atmosphere that caters to the needs of women and their families.
“It’s not just surgery, it’s a relationship. When you first meet eyes and discuss the diagnosis, something special happens. Breast surgery is so much more personal than, say, a knee surgery. My patients know I’m going to be with them every step of the way.” -Dr. Kertrisa McWhite
At the UAB Breast Health Clinic, our trained surgical breast oncologists have dedicated their practice to the treatment of all diseases of the breast, both benign and malignant. We offer prompt, comprehensive, compassionate, state-of-the-art care, individualized to your specific needs.
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Pamela Strickland, MD
Get to know Dr. Strickland
Dr. Pamela Strickland is a board-certified general surgeon with over 23 years’ experience specializing in breast surgery. She provides a full range of surgical services to women with breast cancer and other breast diseases.
After earning her bachelor degree from Mississippi College and her masters from the University of Mississippi, Dr. Strickland received her medical degree from the University of Alabama at Birmingham. She then completed an internship at UT Southwestern/Parkland followed by residency at Huntington Hospital in Pasadena, CA. Dr. Strickland was Chief of Medical Staff at Maxwell Air Force Base for three years before deciding to make Montgomery her home. She joined Montgomery Surgical Specialists in 2008 and left to start her own practice, Central Alabama Breast Care, in 2012. Dr. Strickland is a member of the American College of Surgeons, the American Society of Breast Surgeons, the Society of Surgical Oncology, and the Medical Association of the State of Alabama.
Dr. Strickland serves as a clinical assistant professor within the Division of Surgical Oncology at UAB and works collaboratively with medical oncologists, radiation oncologists, breast radiologists, pathologists, and plastic surgeons to provide multidisciplinary care for breast cancer patients.
Dr. Strickland and her husband Michael are the proud parents of two children. In her spare time, she enjoys reading, movies, and cooking.
Katelin Holmes, DO
Get to know Dr. Holmes
Dr. Katelin Holmes received her medical degree with honors from the University of Pikeville Kentucky College of Osteopathic Medicine. She completed her General Surgery Internship at Medical City Fort Worth Hospital in Fort Worth, Texas. She completed her General Surgery Residency at The University of Texas Health Science Center at Houston in Houston, Texas. She completed specialty rotations within breast surgery during her residency training at MD Anderson in Houston, Texas and the West Clinic in Memphis, Tennessee. Upon graduation of residency, she pursued specialty fellowship training in Breast Surgical Oncology in a Society of Surgical Oncology accredited fellowship through the OhioHealth Grant Medical Center in Columbus, Ohio.
A Sigma Sigma Phi Honors Graduate, Dr. Holmes was also the recipient of the Dean's Award at Kentucky College of Osteopathic Medicine for her graduating medical school class. During her internship year of residency, she received the honor of Intern of the Year for all graduate medical education programs.
Dr. Holmes’s surgical interests include the treatment of breast cancer with hidden scar surgical techniques, sentinel lymph node biopsy, reverse axillary lymphatic mapping, oncoplastic breast surgery, skin sparing mastectomy, nipple sparing mastectomy, prophylactic/risk reduction mastectomy, and male breast cancer. Additionally, her clinical interests include benign diseases of the breast, breastfeeding medicine, breast cancer survivorship, and breast cancer genetic predisposition/high risk screening.
She is an active member of the American Society of Breast Surgeons, Society of Surgical Oncology, and the American College of Osteopathic Surgeons.
Dr. Holmes and her husband are the proud parents of one daughter. They enjoy spending time as a family and doing home improvement projects. In her spare time, you can find Dr. Holmes playing with her rescue pugs, cooking, reading historical fiction, and traveling – particularly when there’s a beach involved.
Kristine Bauer, PA-C
Get to know Kristine
Ms. Bauer received her Master in Physician Assistant Studies from Faulkner University in Montgomery, Alabama and a Bachelor of Science Degree in Biology from the University of Louisiana in Lafayette, Louisiana. A proud member of the American Academy of Physician Associates (AAPA), Kristine has clinical interests in assisting in surgical procedures, Breast Cancer Risk Assessment and Counseling as well as Genetic testing for the BRCA gene and other mutations associated with Breast Cancer. She focuses on continuous follow-ups and surveillance for both cancer and high-risk patients. Board certified with the National Commission on Certification of Physician Assistants, Kristine was awarded the Surgical Excellence Award, which recognizes high quality work in surgical service. In her spare time, she enjoys spending time with her husband and dog, talking to her mother, hiking and cooking.
Ashton Fondren, CRNP
Get to know Ashton
Ms. Fondren received her Dual Master of Science in Nursing degree - Nurse Practitioner and Nurse Educator, from Auburn University in Auburn, Alabama. Prior to completing her Master’s Program, she graduated Magna Cum Laude with a Bachelor of Science in Nursing from Auburn University. Ashton is a proud member of the American Association of Nurse Practitioners and Sigma Theta Tau International Honor Society of Nursing. Board Certified by the American Association of Nurse Practitioners, Ashton has clinical interests in High-risk Screenings, Genetic Testing, and Women’s Health Education. In her spare time, Ashton enjoys interior design, gardening, reading and most importantly, spending time with loved ones and friends
- General Surgery
- Breast Surgery
- Bachelor of Arts – Yale University
- Medical School
- Medical College of Pennsylvania-Hahnemann School of Medicine
- Monmouth Medical Center - General Surgery
- Susan G. Komen/University Of Texas Southwestern - Surgical Oncology
- Baptist Health Affiliations
- Baptist Medical Center South
Our surgeon has extensive experience in the use of diagnostic ultrasound. The use of breast ultrasound in the office often allows us to determine on the first visit that a palpable lump or mammographic mass is a simple cyst that needs no further evaluation or treatment.
Fine needle aspiration
An ultrasound-guided fine needle aspiration uses sound waves to localize a lump or abnormality in the breast or underarm and to guide the needle, allowing cells to be removed from the mass for microscopic examination. It is less traumatic than larger needle biopsies but does not give as much specific information concerning the nature of the mass. It is frequently used when there is a suggestion that lymph nodes under the arm might have cancer in them.
Ultrasound guided core needle biopsy
An ultrasound-guided needle breast biopsy uses sound waves to localize a lump or abnormality in the breast or underarm and to guide the needle, allowing a sample of tissue to be removed for microscopic examination. The procedure is done under local anesthesia through a tiny skin nick, usually on the initial office visit. The needle biopsy procedure is quick, results in little, if any, scarring, and does not involve exposure to radiation.
Ultrasound guided vacuum assisted biopsy
A spring loaded core biopsy device takes samples of tissue from palpable or mammographically detected masses and usually gives an accurate diagnosis. There are times when a different type of biopsy that obtains larger cores of tissue is beneficial. A vacuum assisted biopsy device is able to take multiple cores of tissue with a single insertion of the needle. It is particularly useful when the mass is very small, making it difficult to biopsy it accurately with a spring loaded device. If the mass is within the wall of a cyst, it is also easier to accurately target the lesion with a vacuum assisted device. At times, the entire mass can be removed with these devices.
Insertion of Marking Clip
Regardless of the type of needle biopsy that is performed, we frequently insert a tiny titanium clip into the breast to document the position of the area that has been biopsied. If the biopsy is benign, the clip will remain in the breast but should not cause any trouble. It will not set off scanners in the airport, and you can still have an MRI with the clip in place. If the mass turns out to be a cancer, the clip marks the spot that will eventually need to be removed. The clip can usually be seen with ultrasound, allowing us to make an incision right over the cancer in the operating room.
Risk assessment for breast cancer and for hereditary cancer
It has become increasingly important in recent years to evaluate a woman's risk for developing breast cancer in order to know how to best screen her for early detection of cancer. It is particularly important to estimate that risk when her mammogram has dense breast tissue that might obscure a breast cancer, in order to know whether the risk is high enough to justify screening with ultrasound or magnetic resonance imaging (MRI). At the UAB Breast Health Clinic, we routinely use five different computer models, each of which looks at different risk factors, in order to estimate that risk. In general, if the lifetime risk of breast cancer is at least 20%, high risk screening with MRI is indicated. For women with dense breast tissue on mammography, a lifetime risk of 15% probably justifies MRI screening.
Genetic testing for BRCA and other hereditary mutations
If you meet the criteria for genetic testing, we will discuss the potential advantages of testing with you. Although it can be done on saliva, we generally send a blood sample to a special laboratory that does the testing. It generally takes about a month to get the result, at which time we will discuss the results with you. We may recommend that you see a genetic counselor if your situation warrants that consultation.
Partial mastectomy (lumpectomy)
Since the early 1990's, the preferred surgical treatment for most breast cancer has been breast preservation, frequently referred to as a partial mastectomy or lumpectomy. Many excellent studies in which women were randomly assigned to either mastectomy or partial mastectomy have demonstrated that there is no difference in survival whether a woman chooses mastectomy or breast preservation. The studies were done in the early 1970's, so the follow-up of those patients is very long, and our confidence in the findings is quite high. A partial mastectomy consists of removing the cancer and a small rim of normal tissue around it to be sure all of the cancer has been removed. We usually use ultrasound in the operating room to help us know what tissue to remove, frequently injecting a small amount of blue dye that serves as a visual guide for what to remove. When we cannot feel the cancer, and frequently even when we can feel it, an x-ray of the specimen is taken immediately after removing it in order to determine how close the cancer or the clip marking the spot of the cancer is to the tissue that we have cut across. We have a special x-ray machine in the operating room to x-ray the specimen. The digital images are available within seconds and can be transmitted electronically almost immediately to the breast radiology specialists for review.
A mastectomy is still needed about a third of the time, when the cancer is extensive in the breast and it would be difficult to remove it all without severely deforming the breast. Often, it is difficult to be sure where the borders of the cancer begin and end, making it difficult to know just what part of the breast to remove. Other times, when there is extensive malignant calcification on the mammogram, particularly if it extends up under the nipple, a mastectomy is a better option. Sometimes, when a cancer is too large to allow breast preservation and the borders are distinct, pre-operative (also called "neo-adjuvant" or "induction") chemotherapy or hormonal therapy can shrink the cancer such that it can be removed with less deformity, and the breast can be spared. Mastectomy frequently requires a short hospital stay, usually just overnight unless a major reconstruction procedure is planned, but it is also sometimes done outpatient.
When a mastectomy is necessary, we encourage women to consider immediate reconstruction, and we will make you an appointment to see a plastic surgeon. It is "reconstructive" and not "cosmetic" surgery, and is therefore covered by essentially all insurance companies. Medicaid does have some restrictions on what they will cover. There are many advantages to immediate reconstruction. The psychological advantage is obvious. In addition, the "pouch of extra tissue" is not noticeable when the breast has been reconstructed. One type of reconstruction in relatively young women is a TRAM (Trans Rectus Abdominus Myocutaneous) flap, where skin, fat, and some muscle are tunneled from the abdomen to the breast region to create the new breast. (It is popular with some women because they get a "tummy tuck" in the bargain.) It is a large operation, requires about 4 days in the hospital, and takes about 6 weeks of recovery time, but it gives an excellent reconstruction and does not require artificial implants. In most women over the age of 60 or so, and in some women under that age or in those who do not have enough tummy fat to use, a tissue expander reconstruction is generally used. (Donations of tummy fat from friends and relatives won't work!) This is a smaller operation than a TRAM and usually doesn't extend the overnight hospitalization. It is also sometimes done as an outpatient procedure. At the end of the mastectomy, the plastic surgeon comes in and inserts an expander behind the pectoral muscle. Fluid is gradually added over a period of months through a needle inserted into a valve beneath the skin, until the skin has been stretched enough to accommodate an implant. In an outpatient procedure, the expander is then exchanged for the permanent silicone implant.
Sentinel node biopsy
One of the common places breast cancer spreads is to the lymph nodes under the arm, called the axillary nodes. In the past these nodes were always removed in patients with infiltrating breast cancer in an operation called axillary lymph node dissection. There were several problems with that approach. Many patients (in the range of 25-30% or so) developed a permanent swelling of the arm called lymphedema. In addition, there was a great deal of numbness and discomfort in the axilla (underarm) and upper part of the arm. It was also not a very reliable way of determining whether tumor was present in the nodes. Pathologists all around the country would routinely take one or two samples from the middle of the lymph node and, if no cancer was present there, they would report it as "node negative." We know from many studies that tumor was present elsewhere in the node in 20 -- 30% of patients and was not detected by that method. It was not practical, though, for the pathologist to do a detailed examination of all 15 or 20 lymph nodes. Those problems have been largely resolved by a technique known as sentinel node biopsy. When we give the pathologists a small number of nodes (sentinel nodes) to examine, they can make multiple serial sections through the nodes looking for small amounts of tumor. It is a much more accurate way of finding tumor in the node than the old way of making one or two sections through the center of the node, and it has markedly reduced the risk of lymphedema.
Skin and Nipple Sparing Mastectomy
Over the past two decades, the way we perform a mastectomy has evolved. In performing a "traditional" mastectomy, much of the overlying skin, as well as the nipple areolar complex, is removed. We now know that it is safe to remove much less skin, and even preserve the nipple areolar complex. Studies have demonstrated the safety and feasibility of skin sparing mastectomy and nipple sparing mastectomy in the setting of cancer.
Located within the UAB Medicine Breast Health Clinic right here in the River Region, the Breast & Body Boutique offers a variety of products designed to help women look and feel their best after a lumpectomy or mastectomy.
We provide emotional, educational, and cosmetic support in an atmosphere developed by women, for women. Personal consultants help you choose the products that are right for you from wigs, hats and scarves to bras and prostheses.
Patients seen by appointment only. Call (334) 478-5090 to schedule.