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Research Summary

• Clinical trials of neoadjuvant chemotherapy and targeted therapies for women with breast cancer

• Image guided ablation of breast tumors

• Minimally invasive breast cancer surgery

I serve as Director of Breast Surgical Services at the Dana Farber/Brigham and Women’s Cancer Center. I help oversee the clinical and research efforts of a dozen breast surgeons at the Brigham and Women’s Hospital and Dana Farber Cancer Institute. I am also in charge of the integration of multidisciplinary breast care throughout our system which includes: surgical oncology, medical oncology, radiation oncology, breast imaging, breast pathology, reconstruction surgery, physical therapy, social work and nursing. Together we offer one of the most comprehensive teams of breast specialists in the United States.

My primary area of research is in clinical trials of neoadjuvant chemotherapy and targeted therapies for women with breast cancer. Most women with breast cancer are offered chemotherapy and/or hormonal therapy if their cancer is greater than one cm in size. The benefit of these therapies are for limited number women. My colleagues and I give women upfront therapy and follow the tumor response to these novel agents. Core biopsy specimens are taken prior to therapy, two weeks after the start of therapy and at the time of definitive surgery. Gene array studies looking for tumor response to the different therapy modalities are being pursued. Eventually, breast cancers will be typed and therapy tailored to the individual’s breast tumor characteristics.

	Locally advanced breast cancer before therapy. (Left)
Locally advanced breast cancer after 12 weeks of preoperative chemotherapy with dramatic reduction in tumor volume. (Right)

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DFCI/HCC Pre-operative Clinical Trials

Traditional management of malignant and benign breast tumors has been through surgical excision. With the advent of novel ablation techniques such as focused ultrasound, cyrotherapy, laser and radiofrequency; ablation of the tumor can be done with minimal or no surgical incisions. Using MRI guidance and focused ultrasound for ablation, benign tumors such as fibroadenomas are being treated without surgery. We are also looking at intraoperative MRI and PET scan for the evaluation of margins in breast cancer surgery. Minimally invasive surgical techniques such as skin-sparing and nipple-sparing mastectomy are being used to allow women with breast cancer to undergo mastectomy and reconstruction with removal of the entire breast through the areola. Work is also being done with a technique that minimizes pain and bleeding during and after surgery with breast tumescence. Newer techniques such as sentinel lymph node biopsy and axillary ultrasound with fine needle aspiration biopsy are also being used to minimize the morbidity of axillary lymph node surgery.

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Funding

1. National Cancer Institute -- SPORE in Breast Cancer

2. The Susan G. Komen Breast Cancer Foundation

3. Departmen of Defense

4. InSightec

5. Brigham and Women's Hospital Department of Surgery

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Publications

To access Dr. Mehra Golshan's post-2003 publications, please click here.

Pre-2003 Publications

Kim A, Cacciopo J, Golshan M, Templeton A, Prinz R. "A pancreatic epithelial cyst in an adult treated by central pancreatectomy." J Gastrointest Surg. 2001 Nov-Dec;5(6):634-7.

Golshan M, Lotfi P, Prinz R. “Exploration for multiglandular disease in primary hyperparathyroidism.” Operative Techniques in General Surgery 1999, 1:85-95.

Golshan M, McHenry C, de Vente J, Kalajyian R, Hsu R, Tomashefski J. "Acute suppurative thyroiditis and necrosis of the thyroid gland: a rare endocrine manifestation of acquired immunodeficiency syndrome." Surgery. 1997 May;121(5):593-6.

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Mehra Golshan
MD

Director
Breast Surgical Services
Dana Farber / Brigham and Women's Cancer Center 

Clinical Profile & Contact Information

Research Interests

Breast Cancer
Neoadjuvant Chemotherapy
Targeted Therapies
Tumor Ablation
Minimally Invasive Surgery