David Dershaw '70 M.D.
by Jim H. Smith
photograph: Don Hamerman
Like a lot of young people, D. David Dershaw wasnt
entirely certain what he wanted to do with his life. My
undergraduate experience at Trinity was wonderful, he
remembers. I loved the academic world. It gave me time to
really think about possible careers. He toyed with the
notion of foreign service but ultimately had to concede that
languages were not his strongest suit. He gave strong
consideration to teaching, but he was nagged by a growing
suspicion that ultimately a life in academia wouldnt
satisfy the hunger he felt to somehow be engaged in a daily
confrontation with gritty life-and death-affairs of the real
Only after rejecting those career options did he decide upon a
career in medicine. It might have seemed an obvious choice for a
young man whose father and uncle were physicians. But there was
nothing predictable about how satisfied he would be as a doctor.
As a 21-year-old Trinity undergraduate, he certainly could not
have imagined the extraordinary impact he would have upon the
lives of thousands and thousands of women.
Thirty years later, Dershaw is a professor of radiology at the
Cornell University Medical College and the director of breast
imaging at Memorial Sloan-Kettering Cancer Center in New York. He
sees a lot of women in his practice. Young women. Old women.
Women of all faiths, creeds, and colors. All those variations
aside, they have something in common, and its about as
gritty and real-world as life ever gets.
They come to David Dershaw hoping, praying for good news. More
and more, he is able to answer their prayers. And for many of
them, the good news is that he is able to tell them they have
Right place, right time
After graduating from Trinity in 1970, Dershaw earned his M.D. at
Jefferson Medical College in Philadelphia. He completed his
residency in radiology at the New York HospitalCornell
Medical Center in 1978 and then did a one-year fellowship in
diagnostic radiology at Thomas Jefferson University Hospital in
Philadelphia where he immersed himself in two emergent
technologies that would, over the next few years, utterly
revolutionize radiologyultrasound and computerized
In 1979, he moved to Chicago, where, over the next two years,
he held positions as a staff radiologist at two area hospitals.
The jobs were unsatisfying. So when, late in 1981, he learned
that the radiology department at Memorial Sloan-Kettering wanted
to establish an ultrasound program, he didnt hesitate to
return to New York.
And then something happened that changed his life irrevocably.
When the departments mammography expert retired, Dershaw
was pushed into the role. Mammography, he remembers, was a small
and decidedly low-profile part of Memorial Sloan-Ketterings
radiology practice at that point. Indeed, many physicians saw it
as something of a novelty.
But that was about to change, and David Dershaw was about to
be the beneficiary of being in the right place at the right time.
Early diagnosis saves lives
By the mid-1980s, mammography was routinely being used as a
screening tool for women. And Dershaw, enjoying increasing
success publishing articles about the rapidly evolving
technology, was quickly positioning himself at the forefront of
It was an ideal place for a young man who wanted a life in
daily confrontation with the real world. His professional life
revolved around daily interaction with women who had cancer. He
came to know them and understand their special needs.
And he threw himself, with increasing devotion, into the quest
for better ways to serve them. Since the mid-1980s, Dershaw has
been intimately engaged in research that has led to better
methods for interpreting mammograms, introduction of minimally
invasive needle biopsies to replace surgical biopsies,
significant advances in conservation of breasts after cancer
surgery, and many other advances.
The results of that quest have been near-miraculous.
When I began my practice in mammography, he recalls,
I would routinely see women with cancers large enough to
feel. Today, diagnostic procedures have become so precise that a
tumor is considered large if it is over two centimeters.
Between 25 and 50 percent of all breast cancers detected today
are discovered so early that have not yet become invasive. That
means that the cure rate is now in the 50 to 75 percent range.
And with that increasingly positive cure rate, which only
promises to get better, cancers grip on the collective
imagination has grown more and more tenuous.
A generation ago, cancer was often thought of as a death
sentence, says Dershaw. It was so scary that you just
didnt talk about it. But that has changed for the better.
Improvements in radiology are part of a multidimensional attack
on cancer that has had profound consequences. Because significant
improvements in diagnosis mean cancers are often much smaller
when they are discovered today, treatment has also improved
significantly. At least 50 percent of women with breast cancer no
longer require a mastectomy. And even when a mastectomy is
required, reconstructive surgery has also improved strikingly.
Because there is much less likelihood of mutilation than
there was when I began practicing medicine, women are less
afraid. They now seek diagnosis earlier. And because that,
in turn, means many more lives are saved, when David Dershaw
tells one of his patients that she has cancer, theres a
really good chance that he is giving her good news.
Sometimes, at the end of a long day, Dershaw finds himself
remembering a vibrant young woman he knew all too briefly when he
was still a student at Trinity. She was the wife of one of his
closest friends, and she developed breast cancer when she was
still in her 20s. Despite the best treatment available at that
time, she died.
She died much too young, he says, and it was
not an easy death. In the 1970s, cancer treatment was aggressive
surgery and aggressive chemotherapy with all the horrors that
went with it. When I think about how many women are spared that
nightmare today because of the work we do, its a source of
great satisfaction for me.
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