Mehra Golshan, MD, MBA
New Haven, Connecticut
Professor of Surgery
Deputy Chief Medical Officer for Surgical Services, Smilow Cancer Hospital
Executive Vice Chair, Surgery
Clinical Director of Breast Program, Yale Cancer Center
Yale School of Medicine
New Haven, Connecticut
Improving breast-conserving surgery to decrease the need for additional surgery.
Breast conserving surgery, sometimes called lumpectomy or partial mastectomy, is standard treatment for many non-metastatic breast cancer patients. However, despite advances in imaging techniques, anywhere from 15-40 percent of women must return for additional surgery to remove all the cancer, which has negative ramifications including increased physical and psychological stress, higher healthcare costs, higher rates of infection, and higher mastectomy rates. To address these challenges, Dr. Golshan is conducting two clinical trials to test new approaches to interoperative MRI (iMRI) to reduce re-excision rates. Dr. Golshan is focusing on using MRI during surgery and on identifying cancer biomarkers to achieve excision of the entire tumor
Progress Thus Far
Breast conserving surgery relies on tumor images from the diagnostic MRI, but these are typically performed with the patient lying on their stomach facing the floor, in the prone position, but surgery is performed with the patient on their back, in the supine position. This variation in position can make the tumor more difficult to localize. Dr. Golshan is testing whether adding supine-position intraoperative MRI (iMRI) will reduce re-excision rates. To complement iMRI, he is also testing a technique that can distinguish differences in molecular composition of cells in order to detect sub-clinical cancer in the margins during surgery. The trials are currently enrolling patients at Dana-Farber/Harvard Cancer Center (NCT02956473) and Yale New Haven Hospital (NCT02335671), respectively.
Dr. Golshan will continue the clinical trials at Dana-Farber and Yale. He aims to optimize using iMRI for more accurate margin evaluation with fewer scans, in less time, and detecting residual cancer by identifying new biomarkers that can be evaluated. Lastly, he aims to study patient outcomes to further stratify patients and surgical techniques to de-escalate and refine breast conserving surgery.
Mehra Golshan, MD, MBA, is a cancer surgeon and a nationally and internationally recognized leader in breast cancer treatment and research. In addition to caring for patients, he serves as Deputy Chief Medical Officer for Surgical Services and Director of the Breast Cancer Program for the Yale Cancer Center, Smilow Cancer Hospital, and Smilow Cancer Hospital Care Centers.
Dr. Golshan has led numerous Phase I, II and III clinical trials and translational science innovations impacting the treatment options and outcomes for women. He is an innovator in tailoring surgery and therapy for women with early-stage breast cancer with funding support from BCRF and the National Institutes of Health. He is the principal investigator of several phase II trials aiming to reduce the need for second surgeries or re-excisions in women with breast cancer, one of which uses innovative image-guided operating room capabilities to capture and remove all residual tumor utilizing MRI and mass spectrometry which is used at Yale’s hybrid operating room.
Dr. Golshan prides himself on being an educator having trained and mentored over a hundred breast surgical fellows as well as international surgeons. He has lectured and taught surgeons, trainees, and students nationally and internationally in the field of oncology and breast cancer treatment.
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