The American College of Surgeons is dedicated to improving the care of the surgical patient and to safeguarding standards of care in an optimal and ethical practice environment.

Oct. 11, 2009
Oct. 13, 2009
Oct. 15, 2009

Contents:
• Evolution of trauma care in the U.S. should focus on inclusive systems
• Surgeon shortage one area that health care reform should address
• National Safety Council Surgeons’ Award for Service to Safety
• Distinguished Philanthropist Award
• Award-winning geneticist to participate in Surgical Forum
• Young Fellows Association debuts
• Bernard Fisher, MD, FACS, is recipient of 2009 Jacobson Innovation Award
• No easy answers to medical industry support for CME
• Commission on Cancer Paper Competition winners announced
• ACS-Emerson Scholar-in-Residence in Medical Ethics established

Bernard Fisher, MD, FACS, is recipient of 2009 Jacobson Innovation Award

Dr. Fisher (left) and Dr. Jacobson

Bernard Fisher, MD, FACS, is the recipient of the 15th Jacobson Innovation Award of the American College of Surgeons. The award, which honors living surgeons who have been innovators of a new development or technique in any field of surgery, was presented to Dr. Fisher Saturday evening during the ACS President’s Dinner.

Established in 1994 through a gift from Julius H. Jacobson II, MD, FACS, a general vascular surgeon and pioneer in the field of microsurgery, and his wife Joan, the award is administered by the Board of Regents Honors Committee of the ACS.

Dr. Fisher was honored with the Jacobson award in recognition of his overturning the Halsted anatomic and mechanistic paradigm that had led to radical mastectomy as the standard treatment for breast cancer. He was the first to establish, by means of laboratory and clinical investigation using randomized trials, a scientific basis for breast-conserving surgery. His laboratory investigations in the biology of cancer during the 1960s and 1970s led him to discover evidence of the existence of “dormant” tumor cells. Those studies were instrumental in the recognition of breast cancer as a systemic disease and aided in establishing that: there is no orderly pattern of tumor cell dissemination; positive lymph nodes are indicators of a host-tumor relationship that permits development of metastases; lymph nodes are often ineffective barriers to tumor cell spread; the blood stream is of considerable importance in tumor dissemination; operable breast cancer may already be a systemic disease at diagnosis; and variations in local-regional therapy may not substantially affect survival. In his research during the 1970s and 1980s, Dr. Fisher proved that survival after radical mastectomy was no greater than after total mastectomy and, in turn, that survival after total mastectomy was no greater than after lumpectomy followed by radiation therapy.

His realization that local-regional control of breast cancer in itself was not likely to further affect survival drove Dr. Fisher to design and implement a series of studies that evaluated systemic adjuvant chemotherapy as a possible treatment for cancer. In 1975, he reported the first data to show that postoperative chemotherapy could change the natural history of patients with primary operable breast cancer. In 1989, he published findings from a study that indicated the worth of postoperative chemotherapy for patients with estrogen receptor-negative tumors and of tamoxifen for women with estrogen receptor-positive tumors, thus altering the management of patients with node-negative breast cancer. The following year, Dr. Fisher and colleagues demonstrated that postoperative tamoxifen plus chemotherapy was more beneficial than tamoxifen alone for patients with node-positive or node-negative breast cancer. Dr. Fisher’s findings led him to make a significant contribution to breast cancer prevention. Studies that he reported in the mid-1990s showed that tamoxifen could reduce the incidence of invasive and noninvasive breast cancer by almost 50 percent in women at increased risk for the disease. Dr. Fisher’s work has played a major role in bringing about the improvement in breast cancer survival rates that has recently been reported in Great Britain and the United States.

Dr. Fisher received his medical degree from the University of Pittsburgh (PA) in 1943. Following his surgical residency there, he was a fellow in surgical research at the University of Pennsylvania from 1950 to 1952. In 1953, he returned to the University of Pittsburgh and joined the faculty as an assistant professor. In 1955 he spent a year at the London Post-Graduate Medical School, Hammersmith Hospital, in London, England. He is currently distinguished service professor of surgery at the University of Pittsburgh.

Dr. Fisher’s awards and honors include a Fulbright fellowship, the Albert Lasker Clinical Medical Research Award, the General Motors Cancer Research Foundation’s Kettering Prize, the Bristol-Myers Squibb Award for Distinguished Achievement in Cancer Research, the American Cancer Society Medal of Honor, the Memorial Sloan-Kettering Cancer Center’s C. Chester Stock Award Lectureship, and the Jill Rose Award from the Breast Cancer Research Foundation. In addition, he has received the Distinguished Medical Service Award from the Friends of the National Library of Medicine, the American Association for Cancer Research Award for Lifetime Achievement in Cancer Research, and honorary doctorates from Yale University, Carlow University, the Mount Sinai School of Medicine of the City University of New York, and the University of Pittsburgh. A member of the Institute of Medicine, Dr. Fisher has served on numerous scientific advisory committees and, by presidential appointment, on the National Cancer Advisory Board and the President’s Cancer Panel. An active member of many prominent academic, medical, surgical, and scientific societies, Dr. Fisher has served as president of the American Society of Clinical Oncology.

His most enduring achievement is having changed the course of treatment, the rate of survival, and the quality of life for countless women with breast cancer.