Newswise — Bernard Fisher, MD, FACS, is the recipient of the 15th Jacobson Innovation Award of the American College of Surgeons (ACS). The Jacobson 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 on October 10, 2009, during the ACS President’s Dinner in Chicago.

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 dis-cover 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 tamox-ifen 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.

Since its establishment in 1994, the Jacobson Innovation Award--administered by the Board of Regents Honors Committee of the American College of Surgeons--has been awarded to 15 prestigious surgeons, including Dr. Fisher. Original thought combined with the first pre-sentation of work that has led to a milestone in the advancement of surgical care is the main criterion for choosing a recipient of the Jacobson Innovation Award.

The American College of Surgeons is a scientific and educational organization of sur-geons that was founded in 1913 to raise the standards of surgical practice and to improve the care of the surgical patient. Dedicated to the ethical and competent practice of surgery, the College has more than 75,000 members and is the largest organization of surgeons in the world. An important advocate for all surgical patients, the College has had a significant influence on the course of scientific surgery in America.

Jacobson Innovation Award Previous Recipients

1994: Professor Francois Dubois, Paris, FranceLaparoscopic cholecystectomy

1995: Thomas Starzl, MD, FACS, Pittsburgh, PALiver transplantation

1996: Joel D. Cooper, MD, FACS, St. Louis, MOLung transplantation and lung volume reduction surgery

1998: Juan Carlos Parodi, MD, Buenos Aires, ArgentinaTreatment of arterial aneurysms, occlusive disease, and vascular injuries by using endovascular stented grafts

1999: John F. Burke, MD, FACS, Boston, MADevelopment and implementation of a number of innovative techniques in burn care, including the co-development of an artificial skin (IntegraTM)

2000: Paul L. Tessier, MD, FACS (Hon), Boulogne, FranceDevelopment of a new surgical specialty (craniofacial surgery)

2001: Thomas J. Fogarty, MD, FACS, Portola Valley, CADesign and development of industry standard minimally invasive surgical instrumentation, especially for cardiovascular surgery

2002: Michael R. Harrison, MD, FACS, San Francisco, CACreator of the specialty of fetal surgery and developing techniques of fetoscopy for minimally invasive fetal technology.

2003: Robert H. Bartlett, MD, FACS, Ann Arbor, MIPioneer in the development and establishment of the first extracorporeal membrane oxygenation (ECMO) program

2004: Harry J. Buncke, MD, FACS, San Francisco, CAPioneer in the field of microsurgery and replantation

2005: Stanley J. Dudrick, MD, FACS, Waterbury, CTInnovator of specialized nutrition support and a pioneer in the field of clinical nutrition

2006: Judah Folkman, MD, FACS, Boston, MAPioneer in the field of angiogenesis

2007: William S. Pierce, MD, FACS, Hershey, PAPioneer in the conception and development of mechanical circulatory support and the total artificial mechanical heart

2008: Donald L. Morton, MD, FACS, Santa Monica, CAPioneered research efforts toward the development and clinical application of sentinel lymph node biopsy