Dr. Bernard Fisher's research ended the routine use of radical mastectomy: removing the whole breast, axillary lymph nodes (from the armpit), pectoralis major (the major chest wall muscle) and sometimes the ribs. Although U.S.-based he carried out clinical trials in Alberta.
His research demonstrated that cancers, if caught early enough, could be treated with simpler, less mutilating surgeries, and that chemotherapy and hormonal drugs are effective.
U of A oncologist, Dr. John Mackey, says, "I met Dr. Fisher twice - he was truly an amazing individual and probably the most important breast cancer physician, ever."
The clinical trials entailed three groups of patients receiving: radical mastectomy; a simple mastectomy (removal of the breast alone) with axillary lymph node dissection; and a simple mastectomy with no lymph node dissection but subsequent chest-wall radiation. Published in 1977, the results showed that radical mastectomies were associated with a significant degree of disability and disfigurement, and conferred no improvement in mortality, local recurrence or distant recurrence (spread to other parts of the body). By 1979, simple mastectomy was breast cancer's standard treatment.
Oncoplastic breast surgeon Dr. Lashan Peiris says, "Arguably he produced some of the most ground-breaking studies in the world of surgical oncology. I still mention Dr. Fisher's research at least five to six times a week when I'm talking to patients."
He says, "I recently treated a lady from Edmonton who had been recently diagnosed with breast cancer who happened to be a retired Research Nurse. During our consult, I mentioned Dr. Fisher's work in the context of her decision-making process between breast conservation surgery or a mastectomy. She then told me that she not only had worked with Dr. Fisher on the National Surgical Adjuvant Breast and Bowel Project (NSABP) trials, but he had been to - and stayed at - her home here in Alberta. It seemed quite fitting that she chose to have oncoplastic breast conservation surgery."
The patient, Marilyn Stevenson, was Dr. Fisher's first research nurse in Canada. She organized his first Canadian conference, during which over a thousand attendees from across North America came to Banff. Ms. Stevenson says, "One on one Dr. Fisher was very quiet. But his enthusiasm and passion for his studies lit him up in front of people - he was a most flamboyant and interesting speaker." She says, "he was a very interesting man and I was so fortunate to work with him in Calgary Cancer Clinic when a lumpectomy or simple mastectomy were seen as pie-in-the-sky".
She sees Dr. Peiris' "amazing work" as legacy to Dr. Fisher's: "A woman coming out of surgery feeling good about herself."