Dr. Hershman is the leader for the Breast Cancer Program of Herbert Irving Comprehensive Cancer Center, a PI on the SWOG NCORP research base, and the co-Chair of the SWOG Cancer Care Delivery Committee. She has focused her career on understanding ways to improve breast cancer outcome by identifying factors that are associated with suboptimal breast cancer therapy. While many work to identify new effective therapies with marginal improvements over the standard of care, she has shown that the best therapies are often not started or completed by patients. By identifying subsets at highest risk for poor treatment quality, determining factors that contribute to suboptimal care and by conducting interventional trials to improve compliance with therapy, her work has had an enormous impact on improving quality of life, reducing cost and improving outcome of breast cancer survivors. She has published a series of papers that identify patient, physician and practice characteristics that influence treatment quality. In addition she has documented the influence of insurance and financial factors on receipt of standard treatments. Specifically, she has shown higher co-payment amounts, individual net-worth and brand-name, as opposed to generic drugs are associated with higher rates of early discontinuation of cancer therapy. To improve adherence and outcome, and translate observational findings to interventional trials, Dr. Hershman has conducted several randomized studies of approaches to reduce both chemotherapy and hormone therapy toxicities. In addition to under use of proven therapies she has investigated over-use of procedures and drugs with uncertain benefit. She has evaluated use of new devices, complications associated with robotic surgery and use and risks associated with morcillation.