Dr. Russell H. Patterson III, M.D., F.A.C.S. received his medical degree from the University of Tennessee, Memphis after graduating from Vanderbilt University.  Upon completion of his post-graduate surgical training, he began practicing with his father, Dr. Russell Patterson, Jr., considered by many to this day to be the one of the best surgeons in Memphis.  After more than 25 years of practicing general surgery, Dr. Patterson felt compelled to specialize in the treatment and surgery of diseases of the breast.

Dr. Patterson is determined to make a difference for women faced with a diagnosis of breast cancer.  He has been at the forefront of bringing new surgical techniques in treating this disease to the Mid-South region.  He was one of the first Memphis surgeons to embrace the Lumpectomy procedure when appropriate as an option to mastectomy and was the first to offer the Sentinel Node Biopsy as an alternative to the complete lymph node dissection. 

Dr. Patterson has been instrumental in the development of the Baptist Hospital Comprehensive Breast Center and serves on their Executive Board.  He also serves on the Leadership Council for the Baptist Hospital for Women.  Dedicated to ensuring that women of the Mid-South have access to the absolute best breast care available, Dr. Patterson continues to search for new and innovative treatment options and bring them to Memphis.  His professional expertise and compassionate demeanor lead women to seek out his attention.

Personally, Dr. Patterson has also been touched by cancer.  His wife, Sandy, is a breast cancer survivor.  She co-founded the Wings Cancer Foundation and serves as Wings’ Executive Director.  (Wings provides supportive care programs and services to cancer patients and their families.)  Together, they offer hope and compassion to women faced with this terrible disease.

An avid motorcyclist, Dr. Patterson may be spotted on the back roads of Shelby County or on the peaks of the Rocky Mountains on his Harley Davidson. Meticulous attention to detail and design has made him an accomplished woodworker, craftsman and weekend backyard landscape enthusiast. He is also a passionate distance runner. 

SENTINEL LYMPH NODE BIOPSY
Determining the axillary lymph status with limited lymph node removal
by Russell H. Patterson III, M.D., F.A.C.S.

A component of all surgical procedures for invasive breast cancer in the past has been the removal of all the axillary lymph nodes to determine if tumor cells have spread beyond the tumor in the breast. The presence of tumor cells in the under arm lymph glands is the most important predictor of survival in women with breast cancer.

Recently a new procedure has been developed to evaluate the axillary lymph node status in patients with breast cancer.  Studies of the lymphatic drainage of the breast to the axillary lymph nodes demonstrate consistently that one or two glands receive the lymph drainage initially and the remaining lymph nodes receive their drainage from these initial glands. The lymph node receiving drainage first is called the sentinel lymph node.

If the sentinel node can be identified and removed and found to not contain any tumor cells then no further lymph nodes need be removed.

Injecting blue dye and/or a radioactive isotope tracer into the region of the breast tumor identifies the sentinel node. The sentinel lymph nodes are then removed thru a small incision and analyzed for tumor cells. If none are found, no further glands are removed; however, if tumor cells are found then the remaining glands are removed for analysis.

Limiting the number of lymph nodes removed greatly reduces the subsequent risk of lymphedema and the degree of pain and discomfort is much less than that experienced with complete lymph node removal. Patients with early stage breast cancer who generally have negative lymph nodes will benefit most from this procedure.

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BREAST CONSERVING SURGERY
The Watershed Event In The Surgical Treatment Of Breast Cancer
by Russell H. Patterson III, M.D., F.A.C.S.

From the onset of surgical treatment of carcinoma of the breast until recently the standard and only recommended treatment was mastectomy. Advances in medicine and surgical technique allowed more and more radical surgery for breast cancer, yet no improvement in survival was seen. It has become apparent that in many cases breast cancer is a systemic disease early in its development and that subsequent surgical intervention is to little avail. This concept has been confirmed by investigative clinical trials and has lead to the understanding that there is no survival advantage to mastectomy when compared to breast conserving surgery, generally known as lumpectomy, when this procedure is appropriate.

Candidates for lumpectomy are women with single small tumors located in a peripheral part of the breast and not under the nipple area. The tumor must be removed with a margin of normal breast tissue around the tumor that is clear of any tumor cells.

The lymph modes adjacent to the breast must be evaluated and this is generally done by sentinel lymph node biopsy.

Following breast conserving surgery, radiation therapy is given to the breast to prevent recurrence of disease in the breast. This is accomplished with a course of external beam radiation given over a period of six to seven weeks or, if appropriate, internal partial breast radiation given over a period of five days. 

Women who have undergone lumpectomy and radiation therapy have cure rates equal to those treated by mastectomy and generally have very good cosmetic results.

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MAMMOSITE
A New Method of Delivering Breast Radiation Therapy
By Russell Patterson III, M.D., F.A.C.S.

The surgical treatment of breast cancer has changed greatly over the years. Currently the recommended treatment for early stage breast cancer is partial mastectomy or lumpectomy and sentinel lymph node biopsy. This combined with radiation therapy to the breast yields long term survival results equal to mastectomy. Breast radiation has generally been given by external beam therapy to the entire breast; however, recent experience with interstitial partial breast radiation, (radiation given only to the lumpectomy site by a radiation source placed within the breast), gives equal results for control of local same site recurrence. In addition, there is no higher occurrence of new disease elsewhere in the breast.

In the past, complexities of delivery of consistent radiation dose levels have hindered the use of this mode of therapy. Recently a simplified method of consistent dose delivery has been devised. This new FDA approved technique involves the placement of a balloon type catheter into the breast lumpectomy cavity at or subsequent to the time of lumpectomy. This catheter places the radiation source within the breast cavity. The catheter placed   centrally located within the cavity allows the consistent delivery of radiation to the surrounding breast tissue to a prescribed depth of treatment of about one centimeter, which is the area at the greatest risk for recurrence.

By using a high dose rate system, the total radiation dose can be administered over a much shorter period of time. Conventional external beam radiation requires a total treatment period of six to seven weeks.  Using high dose rate partial breast irradiation, the total dose can be given in five days.

At this time patient selection criteria is restricted to use in patients with the least chance for local recurrence. The treatment will be available to patients forty-five years of age or greater with tumors two centimeters or less in size. There must be no lymph node involvement and no surrounding ductal carcinoma in-situ. The therapy will not be used in patients with ductal carcinoma in-situ only.

The most significant benefit of this new mode of radiation therapy is the shorter length of time needed for completion of treatment. Other anticipated benefits are less skin irritation and fatigue than seen with conventional therapy. Hopefully this will allow more patients to consider breast conserving surgery that would otherwise elect mastectomy because of the length of time involved or the unavailability of conventional radiation therapy.

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