© 2001 by Oxford University Press
Journal of the National Cancer Institute, Vol. 93, No. 12, 897-900,
June 20, 2001
© 2001 Oxford University Press
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Surgical Oncology Focusing on Minimally Invasive Surgery, More Randomized Clinical Trials
Surgery, the oldest treatment for cancer, is turning toward minimally invasive approaches as technology and understanding of cancer improve. Perhaps Bernard Fisher, M.D., breast cancer surgeon from the University of Pittsburgh, deserves the most credit in the United States for moving cancer surgery toward an organ-conserving approach. At the same time, he pushed cancer surgeons toward adopting a higher standard of evidence.
Fisher pressed for randomized controlled trials testing the traditional Halsted radical mastectomy against total mastectomy, and, subsequently, total mastectomy against lumpectomy with or without radiation therapy. He fought hard for those trials, meeting resistance on many fronts. Eventually, clinical trials proved Fisher right: breast-cancer mortality with lumpectomy and radiation was proven equivalent to that attained with more radical surgery. Sure enough, the standard of care for breast cancer surgery slowly moved toward adoption of lumpectomy and radiation, a procedure now well recognized to confer many other benefits.
Fisher
Clinical Trials Gain Momentum