by Bill Snyder
David Page, MD, former professor of Pathology and Preventive Medicine at Vanderbilt University School of Medicine, whose work revolutionized the assessment of breast cancer risk, died in Nashville on Thursday, Oct. 17. He was 78.
Funeral arrangements are pending. Dr. Page died 19 days after his wife, Lauren Ann Pokorny Page. They had been married for 56 years.
In a landmark paper he co-authored in 1985, Dr. Page concluded that not all women with fibrocystic breast changes have an increased risk of breast cancer as had long been presumed.
“As a result of his work, essentially millions of women around the world have benefited from limited surgery rather than radical mastectomy,” which previously was the primary preventive treatment for suspected breast cancer, said his brother-in-law, James O’Neill, MD, professor of Surgery emeritus at Vanderbilt.
A native of New York City, Dr. Page spent part of his childhood in Saudi Arabia, where his father worked as a public health physician for what was then known as the Arabian-American Oil Co., now Saudi Aramco.
Beginning when he was 10 years old, he participated in research studies of malaria and trachoma, a bacterial infection and leading cause of blindness in Saudi Arabia. The experience kindled a lifelong passion for advancing public health.
Dr. Page attended Yale University and earned his medical degree from Johns Hopkins University School of Medicine in 1966. He interned in Medicine at Vanderbilt University Hospital and completed residency training in Pathology at Massachusetts General Hospital, the National Institutes of Health and Johns Hopkins.
In 1972, he was appointed assistant professor of Pathology at Vanderbilt, where he remained throughout his career. Over the years at Vanderbilt University Medical Center, Dr. Page served as director of Surgical Pathology, Cytopathology and Anatomic Pathology.
In the 1970s it was unclear what specific histologic findings in the breast were associated with increased cancer risk. Dr. Page overcame these challenges by developing precise criteria for diagnosing the spectrum of breast changes — from benign to premalignant to malignant — and combining these methods with state-of-the-art epidemiological methods.
He assembled and followed a cohort of 17,000 Nashville-area women who underwent biopsy for fibrocystic breast disease. In collaboration with William Dupont, PhD, professor of Biostatistics and Preventive Medicine, he showed that 70% of these women had no elevation in breast cancer risk compared to other women of similar age.
Their definitive paper on this topic, published in 1985 in The New England Journal of Medicine, radically altered the approach to histologic diagnosis and clinical management of benign breast disease and remains the core of these disciplines today.
Dr. Page authored more than 400 scientific publications. A textbook he co-wrote that was published in 1987, “Diagnostic Histopathology of the Breast,” provided the definitive classification of the complex and diverse lesions that occur in the breast.
Among his many honors was the 1999 Komen Award for Scientific Distinction from the Susan G. Komen Breast Cancer Foundation.
Dr. Page chaired several scientific committees and commissions including the Breast Pathology Committee of the Eastern Cooperative Oncology Group (ECOG), the American Joint Commission on Cancer (AJCC) and the Cancer Committee of the College of American Pathology.
Known as a gifted teacher and generous mentor, he also trained more than 100 surgical and breast pathology fellows, many of whom today are leaders in their fields, and promoted the careers of junior colleagues.
“He took me under his wing as a newly graduated biostatistician,” Dupont said. “I will be forever grateful to him for the mentoring and support that he gave me.”
Dr. Page is survived by his children, Emily Page Pierre and Robert Norman Page, MD; grandchildren Elizabeth Lauren Page and Rebecca Ruth Page; nieces and nephews Jim O’Neill, Elizabeth O’Neill Griffin and Katy O’Neill Miller, and countless friends.
