In Memoriam: Gerald D. Dodd, Jr., MD (1922-2015): Champion of Screening Mammography

Abstract

Screening mammography has been one of the greatest scientific advancements of our time. Numerous randomized trials and service screening studies conducted in Europe have shown that periodic screening can reduce deaths from breast cancer in women aged 40 years and older by as much as 50%. A greater than 30% reduction in the breast cancer death rate in the United States since 1980 has been largely due to the widespread application of high-quality mammographic technique and interpretation. For this accomplishment, women in our country can be grateful to Gerald D. Dodd, Jr., MD, who passed away in Houston, Texas, on September 25, 2015, at age 92. Through his leadership in organizations such as the American Cancer Society (ACS), the American College of Radiology (ACR), the American Board of Radiology (ABR), and the National Council on Radiation Protection and Measurements, Dodd played an indispensable role in the adoption of technical quality requirements by the ACR and the U.S. Food and Drug Administration, the Mammography Quality Standards Act (MQSA), the development of interpretive descriptors used in the ACR Breast ImagingReporting and Data System (ACR BI-RADS), the incorporation of breast imaging on ABR examinations, and the initiation of ACS screening mammography guidelines. During much of his remarkably productive career, Dodd was chairman of the Division of Diagnostic Imaging at The University of Texas MD Anderson Cancer Center in Houston, Texas. He was the imaging editor for Breast Diseases: A YEAR BOOK Quarterly from its inception in 1990 until 2005, when at age 82, he recommended to S. Eva Singletary, MD, then editor-in-chief, that I assume his position. To me, Gerry Dodd was a long-time friend, a trusted mentor, and an inspiration. Dodd was born in Oaklyn, New Jersey, on November 18, 1922. He attended Blair Academy preparatory school, participating with distinction in football, wrestling, and boxing. He received a football scholarship to Cornell University but chose Lafayette College instead, intending to pursue a career in medicine. World War II interrupted his studies, and he joined the U.S. Navy as a hospital corpsman. His commanding officer recommended him to the Officer Training Program through Swarthmore College in suburban Philadelphia, and he was commissioned with the rank of ensign. After the war, he returned to Lafayette, graduating in 1945. In 1946, he married his beloved wife of 68 years, Helen Glenzing. He received his medical degree from Thomas Jefferson Medical College in Philadelphia, Pennsylvania, in 1947 and was elected to the Alpha Omega Alpha Honor Medical Society. (Many years later, he was selected for the prestigious Thomas Jefferson University Alumni Achievement Award.) In 1948, he interned at Fitzgerald Mercy Hospital in Darby, Pennsylvania. His ensuing residency in radiology at Thomas Jefferson Medical College, under Dr. Paul Swenson as chairman, ran from 1948 to 1950. During the Korean War, he joined the U.S. Air Force, rising to the rank of captain, while serving as the chief of radiology at Mitchell Air Force Base in New York. Dodd began his highly productive career as an assistant professor at Thomas Jefferson Medical College (1952-1955). He then relocated to MD Anderson, where he served as section head of diagnostic imaging from 1955 to 1961. During that time, Dodd assigned Robert L. Egan, then a resident in radiology, the task of developing a mammographic technique for the staging of breast cancer. Egan’s landmark accomplishment demonstrated that mammography can reduce errors in preoperative diagnosis and reveal unsuspected lesions. Disappointed by the lack of support for diagnostic radiology at MD Anderson at that time, Dodd returned to Jefferson in the spring of 1961 as chief of diagnosis and director of residency training. Under the leadership of Dodd and Dr. Philip J. Hodes, chairman of radiology, the department experienced a dramatic growth in the resident program. During the 1950s and 1960s, Philadelphia was a leading center for clinical studies in the emerging field of breast imaging. Dr. Jacob Gershon-Cohen at Albert Einstein Medical Center was developing improved mammographic techniques, correlating the mammographic, pathologic, and clinical findings of breast diseases, and investigating the value of mammography for screening. At Jefferson, Dodd coauthored a cooperative study of mammography at 7 Philadelphia teaching hospitals, initiated byDr. Eugene P. Pendergrass, chairman of radiology at the University of Pennsylvania. Their results confirmed that mammography could detect clinically unsuspected breast cancer. While at Jefferson, Dodd was the first in the country to develop a preoperative needle localization technique for nonpalpable breast lesions. This major technical innovation increased the accuracy of excisional biopsy while decreasing postoperative deformity. In 1964, Dodd and John D. Wallace, a medical physicist at Jefferson, began to assess the relationship between breast tumors and mammographic vascularity. Their studies led them to evaluate thermography, a technique that depicts the infrared radiation emitted by the superficial vasculature of the breast, as a potential screening modality.