COMMENTARY

Remembering Bernie: An Early Champion in Breast Cancer

Kathy D. Miller, MD

Disclosures

November 01, 2019

This transcript has been edited for clarity.

Good morning, everyone. I'm Dr Kathy Miller from Indiana University, and I'm here to tell you a story.

On a good day, God made a mixture of passion, determination, and smarts, and he called that mixture Bernie. Those of us in the breast cancer world know that Bernie can only mean Dr Bernard Fisher, who left us not long ago after 101 amazing years on this earth.

Very early in my training, I remember asking a mentor why breast cancer seemed like it had advanced faster than colon cancer or lung cancer. Was it that the biology of the disease was more favorable? Did we have an easier tumor? He laughed and said, "Maybe, but really it's because we have Bernie."

What he meant is that we had Bernie—we had a surgeon who was passionate about research.

Bernie was famous for reminding us all that in God we trust; everybody else has to have data. You don't assume things that you can prove—you get the data. For Bernie, the data often started in the basic laboratory but continued into the clinic.

He was passionate about the role of clinical research and challenging the surgical dogma that had existed for 50 years. Only someone with incredible smarts, determination, and passion—that force of nature—would have been able to mount those early studies, gradually moving from radical mastectomy to modified radical mastectomy to lumpectomy to sentinel node biopsy.

Bernie was an early champion of the role of systemic therapy, making us all recognize that breast cancer was not a local disease to be solved by more and more extensive local therapy.

He also challenged us to think about prevention. That's an insight that came from those early studies when they realized that hormone therapy also reduced contralateral breast cancers, as well as distant recurrence and overall survival. That's why we're here today.

Bernie certainly did not work in isolation. He was joined by equally smart and passionate medical oncologists. He was clearly bolstered by statisticians who recognized the need for much larger clinical trials to be appropriately powered in order to find clinically relevant differences on which we could build.

But all of those people needed Bernie. We were all so much the richer for having known him, and for having benefited from his wisdom, passion, determination, and smarts.

Please take a moment to remember Bernie. Look around and see all of the things that wouldn't be here today or would have taken longer to get here had we not had Bernie as one of our early champions.

Kathy D. Miller, MD, is associate director of clinical research and co-director of the breast cancer program at the Melvin and Bren Simon Cancer Center at Indiana University. Her career has combined both laboratory and clinical research in breast cancer.

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