Bernard Fisher: US surgeon who pioneered a scientific approach for breast cancer treatment

The US surgeon Bernard Fisher has died at the age of 101. As chairman of the National Surgical Adjuvant Breast and Bowel Project (NSABP) he undertook the landmark studies that ended mutilating radical mastectomy and, for primary breast cancer, established preoperative and postoperative chemotherapy and tamoxifen as adjuvant treatments. Fisher, who worked at the University of Pittsburgh, was widely credited with launching the scientific approach, where breast cancer treatments were based on results from research using large scale randomised clinical trial methods. He was one of the first translational clinicians to recognise that laboratory investigations and clinical trials were inexorably linked.

“Bernard Fisher was a titan. His research improved and extended the lives of untold numbers of women with breast cancer. His work overturned the dominant paradigm of cancer progression and, to the benefit of all, demonstrated the systemic nature of metastasis,” says Arthur Levine, senior vice chancellor for health sciences at the University of Pittsburgh School of Medicine.

“Women in the US should erect a statue to Bernie because he changed breast cancer surgery from the horrendous Halsted operation (involving the breast being removed, the muscle wall denuded, and lymph drainage disrupted) to a more compassionate procedure resulting in far less morbidity,” says Vincent DeVita, professor of medicine at the Yale Cancer Center, who was the director of the National Cancer Institute from 1980 to 1988.

In 1957 the career of Fisher, who at the time was researching liver regeneration and the metastatic spread of tumour, changed direction when he received a phone call from his former mentor, Isidor S Ravdin, requesting attendance at a meeting at the National Institutes of Health to discuss the creation of the Surgical Adjuvant Chemotherapy Breast Project, later known as the National Surgical Adjuvant Breast and Bowel Project. “I wasn’t the least bit …