Seeking to help accelerate crucial breast cancer research, the Haley Cremer Foundation awarded a $10,000 research grant to Dr. Mehra Golshan at the Dana-Farber Cancer Institute in Boston. “The Foundation is pleased to continue our support for Dr. Golshan and Dana-Farber,” stated Ivie Cremer, the Foundation President. “The research studies Dr. Golshan and his team are doing in the areas of triple-negative breast cancer (TNBC) and ductal carcinoma in situ (DCIS) are crucial to enabling the development of advanced treatments for patients with these cancers”.
“I am so humbled and honored to receive this incredible support from the Haley Cremer Foundation” “The Foundation has been such an instrumental part of our research efforts in tailoring surgery to the patient’s tumor and not giving a one size fits all approach to cancer care,” commented Dr. Golshan. “My groups research would not have been possible without this sustained generous support”.
The Foundation’s grant was matched by an anonymous donor.
Dr. Golshan’s Research Updates:
Triple-negative Breast Cancer Studies
BrighTNess is a multi-phase international trial looking at breast conservation for women with triple-negative breast cancer (TNBC) who are treated with neoadjuvant systemic therapy (NST)—a type of chemotherapy used in patients to make their inoperable breast cancers operable by shrinking the tumors. TNBC accounts for nearly 15 percent of all breast cancers, and the only treatment currently approved for women with early-stage TNBC is chemotherapy. In phase III of the BrighTNess trial, Dr. Golshan and his team assessed the results after patients underwent either lumpectomy or mastectomy after NST and found that NST increased eligibility for women with TNBC to undergo lumpectomy—the less radical breast surgery. Dr. Golshan and his team are now tracking outcomes of these patients for recurrence, death, and survival rates. Dr. Golshan and his team are also currently reviewing MRI data to determine if it can predict a TNBC patient’s response to drug therapy and help their surgeon make decisions regarding treatment.
Dr. Golshan and his team continue to participate in a unique trial designed to achieve clear margins—the boundary of healthy, cancer-free tissue that should remain after the surgical removal of a tumor. Obtaining clear margins during surgery can lead to improved long-term prognosis for patients, reduce the delay in receipt of adjuvant therapy, and decrease infection rates. To determine the best surgical approaches for achieving clear margins, Dr. Golshan performs surgeries in BWH’s AMIGO suite—a state-of-the-art medical and surgical research environment that houses a complete array of advanced imaging equipment and interventional surgical systems, including magnetic resonance imaging (MRI), positron emission tomography (PET) scanners, computerized tomography (CT) scanners, mass spectrometry devices, and other imaging modalities. Using the AMIGO suite, Dr. Golshan can accurately view tumor margins in real time during surgery, increasing his ability to obtain clear margins in a single procedure.
Because of Dr. Golshan’s success using the AMIGO suite during this clear margins trial, the BWH Department of Radiology is now having all patients with breast cancer undergo MRI prior to surgery while lying in two positions—on their stomach and on their back—in order to get a clearer picture of their tumor.
Ductal Carcinoma in Situ Studies
Dr. Golshan and his team are advancing several projects investigating ductal carcinoma in situ (DCIS)—a condition in which abnormal cells replace healthy epithelial cells in breast ducts. Current treatment guidelines recommend all forms of DCIS be treated with either lumpectomy—with or without radiation—or mastectomy. To determine the efficacy of these guidelines, Dr. Golshan analyzed patient outcomes of women who had received surgery and radiation therapy versus women who received surgery only. He found that women with more aggressive or progressed DCIS may benefit from a combined regimen of lumpectomy and radiation therapy, which has also been found to lower recurrence rates. Dr. Golshan was also the first to identify a subset of women who may benefit from limited surgery or require no surgery at all. Dr. Golshan is currently validating these findings as a principal investigator on the Comparison of Operative to Monitoring and Endocrine Therapy (COMET) trial. The goal of this national trial, which investigates the use of active surveillance for DCIS versus regular surgical management, is to move toward minimal use of surgery when less invasive treatments can suffice and to develop new therapies for women with DCIS. The trial is ongoing and Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC) is currently the leading accrual site for patient samples in the U.S.