Bernard Fisher
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.
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.
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