Bernard Fisher
University of Pittsburgh School of Medicine
For shaping the character of modern breast cancer treatment, thus lengthening and enriching the lives of women suffering from this disease.
Each year more than 119,000 women in the United States develop breast cancer. Dr. Bernard Fisher has done more than any other single individual to advance the understanding of the clinical biology of breast cancer. He has conceptually reshaped and improved the treatment of breast cancer, extending and enriching the lives of women suffering from this dread disease.
In the late 1950s and throughout the 1960s, Dr. Fisher demonstrated that the regional lymph nodes were not a barrier to the dissemination of tumor cells, as postulated earlier, but were routes traversed by tumor cells to gain access to the circulating bloodstream and lymphatic system. Out of this basic work on cancer metastasis came a new model for the management of breast cancer based on the premise that the disease is systemic from its inception.
Dr. Fisher conducted the first prospective randomized trial which demonstrated that the use of a single chemotherapeutic agent after surgical treatment could reduce the incidence of recurrence of the disease. In 1967, he became chairman of the National Surgical Adjuvant Breast Project, which has brought together 3385 physicians from 251 collaborating major medical centers throughout the world. These physicians have conducted 17 trials involving more the 16,500 women, which confirmed Dr. Fisher's early observations and provided definitive evidence that adjuvant chemotherapy could alter the natural history of breast cancer. Approximately 5000 lives are saved each year due to the use of adjuvant chemotherapy.
In other prospective randomized trials, Dr. Fisher demonstrated that in certain well-defined cases, simple mastectomy (removal of the breast) or lumpectomy followed by radiation provided disease-free and overall survival rates equivalent to the more radical forms of surgery, which not only removed the breast but also the surrounding muscle and lymph nodes. From 1972 to 1981, the use of radical mastectomies has declined progressively from 46.8 percent to 4.5 percent. Each year from 55,000 to 60,000 women in the US have breast cancer of 4 cm or less and are eligible for this breast-preserving therapy.
To Dr. Bernard Fisher, for his pioneering studies that have led to a dramatic improvement in survival and in the quality of life for women with breast cancer, this 1985 Albert Lasker Clinical Medical Research Award is given.
