{"entity":{"id":"bernard-fisher","kind":"person","name":"Bernard Fisher","aka":[],"tldr":"He argued that breast cancer is a systemic disease from early on, then proved in randomised trials that lumpectomy with radiation equals mastectomy and that tamoxifen after surgery, and even before cancer, saves lives.","summary":"Bernard Fisher (1918-2019) was a surgeon at the University of Pittsburgh who chaired the National Surgical Adjuvant Breast and Bowel Project from 1967 to 1994. Against the Halsted doctrine that breast cancer spread in orderly fashion and demanded ever more radical surgery, he proposed that it was systemic early and could only be controlled with systemic treatment, and he insisted on randomised trials to test it. NSABP B-04 and B-06, reported in 1985 with twenty-year follow-up in 2002, showed that lumpectomy with radiotherapy gave the same survival as mastectomy; B-14 established adjuvant tamoxifen; and the P-1 trial in 1998 showed tamoxifen could prevent breast cancer in women at high risk. In 1994 a data fraud by a Montreal investigator led to his removal; the findings were confirmed and he was later vindicated and honoured with the Lasker Award and the American Association for Cancer Research's lifetime award.","asOf":"2026-09-09","wikipedia":"https://en.wikipedia.org/wiki/Bernard_Fisher_(scientist)","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Bernard_Fisher_(scientist)"},{"label":"NRG Oncology (NSABP legacy)","url":"https://www.nrgoncology.org/"}],"tags":["hero","pioneer"],"related":[],"cancers":["breast-hr-positive"],"sections":["surgery","hormonal"],"technologies":["endocrine-therapy","chemoprevention"],"targets":[],"drugs":["tamoxifen"],"companies":["nrg-oncology"],"institutions":[],"pathways":[],"terms":["neoadjuvant-adjuvant"],"trials":[],"people":["rose-kushner"],"bottlenecks":["b-surgery-radiation-innovation","b-trial-design","b-toxicity-qol"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"role":"Surgeon whose NSABP trials ended the radical mastectomy and established adjuvant therapy","specialisms":["Breast surgery","Clinical trials","Adjuvant therapy","Chemoprevention"],"profiles":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Bernard_Fisher_(scientist)"},{"label":"NRG Oncology (NSABP legacy)","url":"https://www.nrgoncology.org/"}],"papers":[{"title":"Twenty-Year Follow-up of a Randomized Trial Comparing Total Mastectomy, Lumpectomy, and Lumpectomy plus Irradiation for the Treatment of Invasive Breast Cancer","journal":"New England Journal of Medicine","year":2002,"doi":"10.1056/nejmoa022152"},{"title":"Lumpectomy and radiation therapy for the treatment of intraductal breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-17.","journal":"Journal of Clinical Oncology","year":1998,"doi":"10.1200/jco.1998.16.2.441"},{"title":"Tamoxifen, Radiation Therapy, or Both for Prevention of Ipsilateral Breast Tumor Recurrence After Lumpectomy in Women With Invasive Breast Cancers of One Centimeter or Less","journal":"Journal of Clinical Oncology","year":2002,"doi":"10.1200/jco.2002.11.101"}]},"route":"/people/bernard-fisher/","neighbours":{"cancer":[{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"}],"section":[{"id":"hormonal","kind":"section","name":"Hormonal Therapy","route":"/fronts/hormonal/"},{"id":"surgery","kind":"section","name":"Surgery & Interventional","route":"/fronts/surgery/"}],"technology":[{"id":"chemoprevention","kind":"technology","name":"Chemoprevention & risk-reducing surgery","route":"/technologies/chemoprevention/"},{"id":"endocrine-therapy","kind":"technology","name":"Endocrine therapy (SERMs, AIs, SERDs)","route":"/technologies/endocrine-therapy/"}],"drug":[{"id":"tamoxifen","kind":"drug","name":"Tamoxifen","route":"/drugs/tamoxifen/"}],"company":[{"id":"nrg-oncology","kind":"company","name":"NRG Oncology","route":"/companies/nrg-oncology/"}],"term":[{"id":"neoadjuvant-adjuvant","kind":"term","name":"Neoadjuvant / adjuvant / perioperative","route":"/terms/neoadjuvant-adjuvant/"}],"person":[{"id":"rose-kushner","kind":"person","name":"Rose Kushner","route":"/people/rose-kushner/"}],"bottleneck":[{"id":"b-surgery-radiation-innovation","kind":"bottleneck","name":"Surgery and radiotherapy cure most, get least","route":"/bottlenecks/b-surgery-radiation-innovation/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"},{"id":"b-trial-design","kind":"bottleneck","name":"Trial design, endpoints and cost","route":"/bottlenecks/b-trial-design/"}]}}