The research interests of Tina J. Hieken, M.D., are diverse and include clinical and translational investigations focused on breast cancer and melanoma. Her specific interests include novel technologies and minimally invasive techniques, quality metrics and quality improvement, clinical applications of molecular signatures in cancer, prediction of lymph node metastasis, and benign and malignant breast disease.
- Minimally invasive surgical oncology and cancer outcomes. She is investigating sentinel lymph node dissection and selective minimal access lymphadenectomy, as well as skin and nipple-sparing mastectomy.
- Breast and axillary ultrasound and advanced imaging modalities. Dr. Hieken is studying the preoperative assessment of axillary nodal disease burden to facilitate individualized surgical treatment.
- Tumor biology. She is researching the prediction of pathologic response to neoadjuvant therapy using information on tumor biology, along with assessment of imaging response to treatment. She is also working on a response grading system and algorithms to predict axillary nodal status.
- Melanoma and lymph node metastasis. She is examining the interplay between primary melanoma and stroma biologic features and the development of lymph node metastasis and risk of disease recurrence.
- Quality metrics and assessment. Dr. Hieken is involved in the development of robust quality metrics to assess excellence in the surgical treatment of cutaneous melanoma patients. Additionally, she in interested in implementing team-based clinical pathways to improve surgical outcomes and maintain improvements and metrics for real-time assessment of progress.
- Benign breast disease. In an effort to enhance breast cancer risk stratification and develop individualized risk-reduction strategies, Dr. Hieken is investigating the clinical applications of understanding benign breast disease.
Significance to patient care
Breast cancer remains a significant public health challenge, and the emotional and physical toll of surgical treatment can be a significant detriment to patient well-being, even when a favorable prognosis is expected. Efforts to identify at-risk patients and individualize and minimize surgical treatments have the potential to improve the quality of life and cancer-specific outcomes for hundreds of thousands of breast cancer patients.
The incidence and death rate from melanoma continues to rise more rapidly than any other cancer. Current curative treatments remain primarily surgical despite recent advances in immunology and molecular biology of melanoma. Optimization of surgical oncologic outcomes while decreasing treatment-related morbidity requires advances in understanding the mechanisms that govern metastatic spread to the regional lymph nodes and beyond. This research has the potential to improve both short- and long-term patient outcomes.