In this episode of the Cancer History Project podcast, Dr. Melvin Silverstein reflects on his groundbreaking work in breast cancer care—especially his role in changing how doctors treat and think about ductal carcinoma in situ (DCIS). Interviewed by Dr. Stacy Wentworth, Silverstein shares stories from his decades-long career, including founding the Van Nuys Breast Center—the first free-standing breast center in the U.S.—and challenging widely accepted norms in cancer treatment.
Silverstein is best known for developing tools like the Van Nuys Prognostic Index, which helped personalize DCIS treatment at a time when all patients were typically treated the same. He believed not every woman with DCIS needed aggressive treatment like radiation, and he worked hard to back that up with research. Though his views were controversial in the beginning, they opened the door to more individualized, risk-based care that is now supported by recent clinical studies.
A passionate advocate for patient-centered care, Silverstein made sure that emotional and psychological support were part of the treatment plan. He hired a psychiatrist to work at his clinic and emphasized the importance of truly listening to patients. He believed that understanding the patient’s experience was just as important as understanding the disease.
Today, Dr. Silverstein continues to mentor young surgeons and advocate for smarter, more compassionate breast cancer care. His legacy reminds us that innovation in medicine often starts with the simple act of asking, “What’s best for the patient?”