The Radicalization of Breast Cancer Surgery: Joseph Colt Bloodgood's Role in William Stewart Halsted's Legacy

Johns Hopkins's surgeon William Stewart Halsted is renowned for popularizing the radical mastectomy, a disfiguring procedure that was overutilized during the 1900s. Cancer historians have questioned why Halsted, a meticulous surgical investigator, became more aggressive in his approach to breast cancer surgery when his own data failed to show prolonged patient survival. Joseph Colt Bloodgood, one of Halsted's early surgical residents, Hopkins's head of surgical pathology, and Halsted's primary outcome data analyst, played previously unrecognized roles. Bloodgood was an aggressive surgeon with a "lynch law" approach to breast lesions. As a surgical pathologist, Bloodgood was irrationally opposed to intraoperative frozen section diagnosis. Bloodgood's and Halsted's unwavering trust in each other created an environment where shared beliefs trumped surgical reality. However, after Halsted's death, Bloodgood recognized that they had been wrong and spent the rest of his life trying to reverse the progression while simultaneously "rewriting" details of his own involvement.