Ranjna Sharma, MD

Assistant Professor of Surgery, Harvard Medical School


 

Research Focus

Clinical Research

Outcomes of breast cancer treatment in the high risk octogenarian patient population

This study is a retrospective review evaluating treatment outcomes in patients aged 80-89 who were diagnosed with early-stage, high-risk breast cancer between the years of 2000-2010. The high risk cohort was defined as patients with triple negative disease, Her2+ tumors, and/or Grade 3 tumors.

Clinical treatments and outcomes of patients with Phyllodes tumors of the breast: a modern case series

This is a retrospective study looking at our institutional experience with this patient population to better understand management patterns and propose treatment plans for patients with this diagnosis in the future. We will evaluate each patient's margins of resection, use of adjuvant radiation therapy, and rates of local and distant recurrence.

Analysis of delayed hormonal therapy and its impact on morbidity and mortality in women with breast cancer

In this study, the National Cancer Database will be used to study patients with ER+ breast cancer and the initiation time point of adjuvant endocrine therapy to determine reasons for delay in initiation of endocrine therapy and if the time of initiation has an impact on survival.

Can pre-operative axillary imaging predict nodal disease burden at the time of axillary lymph node dissection in patients with locally advanced breast cancer?

This study is a retrospective review of breast cancer patients from a single institution’s tumor registry over a 10-year time period. We are evaluating pre-operative axillary imaging with ultrasound and/or MRI to assess disease burden in axillary lymph nodes and correlate these findings with the amount of disease at the time of axillary lymph node dissection in patients with biopsy-proven axillary disease.

Translational research

Intraoperative real-time breast cancer margin assessment with nonlinear microscopy

We have developed a protocol using Acridine Orange dye with nonlinear microscopy for intra-operative evaluation of surgical margins in oncologic resection specimens. This study is currently in the pre-clinical phase.

Genomic analysis of risk factors for local recurrence after wide local excision for DCIS of the breast

In this study, tissue specimens of patients diagnosed with ductal carcinoma in situ (DCIS) are undergoing genomic analysis to assist in determining risk of disease recurrence. This genomic data will be coupled with clinicopathologic features to better understand risk of disease recurrence.

Accomplishments 2016-2017

Promotion to Assistant Professor of Surgery

Director of Breast Surgery, BID-Needham

Co-Director of BreastCare Center BID-Needham

Certificate in Applied Biostatistics, Harvard Medical School (HMS)

Fellow, American College of Surgeons

Member, DFCI/HCC SRC-3/IRB-D

Member, BIDMC Cancer Committee

Medical Chart Reviewer for Quality Assurance, BIDMC Cancer Committee Tumor Registry

Course Director, Multidisciplinary Breast Tumor Board

Selected to Society of Surgical Oncology Committee membership:  Constitution and Bylaws Committee, Continuing Medical Education Committee

Selected to ACS Massachusetts Chapter Young Fellows/Residents Committee

Teaching, Training, and Education

Patient-Doctor II Course: Lifestyles of a Surgeon

HMS/BIDMC Pre-Internship Surgical Boot Camp: Taught fourth-year Harvard Medical School students fine-needle aspiration, core biopsy, and incision and drainage techniques

HMS General Surgery Clerkship Tutorial leader

Clinical Scholarship Program projects:

  • Clinical treatments and outcomes of patients with Phyllodes tumors of the breast: a modern case series; Gabrielle Cervoni, MD, general surgery resident
  • Analysis of delayed hormonal therapy and its impact on morbidity and mortality in women with breast cancer; Nicole Moraco, MD, general surgery resident
  • MIT Student Introduction to Surgery Program
  • Boston University Shadowing Program

Selected Publications

Manders JB, Kuerer HM, Smith BD, McCluskey C, Farrar WB, Frazier TG, Li L, Leonard CE, Carter DL, Chawla S, Medeiros LE, Guenther JM, Castellini LE, Buchholz DJ, Mamounas EP, Wapnir IL, Horst KC, Chagpar A, Evans SB, Riker AI, Vali FS, Solin LJ, Jablon L, Recht A, Sharma R, Lu R, Sing AP, Hwang ES, White J; Study investigators and study participants. Clinical utility of the 12-gene DCIS Score Assay:  Impact on radiotherapy recommendations for patients with ductal carcinoma in situ. Ann Surg Oncol 2017;24(3):660-668.

Linsk A, Mehta T, Dialani V,  Chadashvilli T, Houlihan MJ, Johnson NB, Brook A, Sharma R. Surgical upgrade rate of breast atypia to malignancy: An academic center’s experience and validation of a predictive model.  Breast J 2018;24(2):115-119.
Van Paridon MW, Paul MA, Kamali P, Ibrahim AMS, Kansal KJ, Houlihan MJ, Morris DJ, Lee BT, Lin S, Sharma R.  Oncoplastic breast surgery: Achieving oncological and aesthetic outcomes. J Surg Oncol 2017; 116 (2):195-202.

Mele A, Mehta P, Brook A, Recht A, Slanetz PJ, Sharma R. Breast conserving surgery alone for ductal carcinoma in situ: Factors associated with increased risk of local recurrence. Ann Surg Oncol  2017;24 (5):1221-1226.

Sharma R, Shulman LN, James T. The future of quality improvement in breast cancer: Patient-reported Outcomes. Am J Med Qual. 2017;32(5):469-47.

Mamtani A, Gonzalez JJ, Neo D, Friedman R, Recht A, Hacker MR, Sharma R. Treatment strategies in octogenarians with early-stage high-risk breast cancer. Ann Surg Oncol. 2018;25(6):1495-1501.