Early on, Esserman learned how critical it is to listen to patients. She will never forget what one woman said after her disease had progressed and she needed a mastectomy: “You’re going to take my breast off, and I’m going to die anyway.” “And near the end,” Esserman recalls, “she told me, ‘See, it’s just like I said.’”
That experience taught Esserman that no course of treatment is right for every patient. Each must choose for herself, and there’s no room in the decision for a doctor’s ego. “When the options are not acceptable,” she says, “we must work harder to find solutions that are.”
The understanding that breast cancer is not just one disease drives Esserman’s research. “Our job is to discover as much as we can about the biology of each breast cancer and determine how well the treatments work for each, so patients can make informed decisions,” she says.
UCSF is the most collaborative place I’ve worked. I am so much more capable because of the people I work with. Here, science is a team process.
In one of Esserman’s groundbreaking initiatives, called ATHENA, doctors and researchers from five UC medical centers are collaborating on the care of 150,000 women to understand why some develop breast cancer and to find more effective ways to customize prevention and treatment. Another effort—the I SPY Trial, involving 20 major U.S. cancer centers—is characterizing breast cancers according to distinctive molecular markers and using an innovative trial design to test which promising new drugs have the greatest impact on different tumor profiles.
Both efforts support the collaboration Esserman thinks is essential to discovery. And both put Esserman on the brink of breakthroughs that will enable doctors to tailor therapies to each woman’s tumor and even prevent breast cancer—work that will accelerate when UCSF’s women’s and cancer hospitals share a modern campus with researchers at Mission Bay.
Returning to the patients who motivate her work, Esserman recalls artist and UCSF patient Anne Chamberlain, who died in 2008. Determined to add patients’ voices to the healing process, Chamberlain rallied more than 1,000 women to share their stories, creatively captured in the tile wall at the entrance to the UCSF National Center of Excellence in Women’s Health. “You can’t walk by without remembering why we are here,” Esserman says. “We are here to answer scientific questions, yes. But we are really here to honor these women and their stories, and to dedicate ourselves to bringing hope and better outcomes to all the women who follow.”
