Adele Francis was a breast cancer surgeon at the Queen Elizabeth Hospital, Birmingham. She was born in Solihull on 19 March 1957. Her father ran a printing business in Birmingham. She spent much of her childhood in Solihull, growing up with her sister Lorna, with the family moving out to Lapworth, Warwickshire, in her teens. She was a keen horsewoman and had her own pony, which occupied a lot of her spare time in her teenage years. She completed her schooling in Solihull, before moving to London to undertake a BSc in biology. As she proved later in life, a BSc was not enough and she went on to complete a PhD and she would often comment on her time with tomato seeds. With this background in lipid chemistry, she moved to a role at Sheila Sherlock's laboratory at the Royal Free Hospital, before moving to the research laboratories attached to the renal unit at the Queen Elizabeth Hospital, Birmingham. In 1986, with her background in medical research, she entered a fast track medical course at the University of Birmingham, qualifying in 1990. She then decided on a career in surgery and set out to pass the college examinations. She undertook the Sloan course and triumphed in her primary examination and undertook a two-year junior registrar rotation in Birmingham working at Dudley Road Hospital, Queen Elizabeth Hospital and Birmingham Children's Hospital. This set her on course to achieving a post as a registrar on the West Midlands rotation and she completed her FRCS (in general surgery) and gained her CCT (certificate of completion of training) in July 2000. She was appointed as a consultant surgeon at the Queen Elizabeth Hospital in 2001, having taken a short break to spend more time with her young daughter. Having first established herself as a key member of breast team, she started to develop her research portfolio. The initial plan of a trial looking at the role of Cox-2 inhibitors in breast cancer was nearly prevented following the results of a long-term adjuvant trial in colorectal disease, but her persistence came to the fore. She cajoled Pfizer and Cancer Research UK into supporting the study and providing the required funding and placebo-controlled medication. As a result, she delivered the trial, completing recruitment and demonstrating an impact of this approach in breast cancer therapy. This trial started her signature approach to trial recruitment with a penguin as the mascot of the trial and, as a reward for recruitment, centres would be sent a penguin soft toy. Adele was a consummate clinician, developing a reputation across the West Midlands, with requests for advice becoming an increasing part of her workload. She helped develop the reconstructive service and delivered the nipple reconstruction and tattooing service for some years. To ensure everyone had access to the best information, she established the breast academic meetings, where she would engage national and international speakers to come and present the latest information on all aspects of breast cancer care. These have been a focus for the breast cancer community across the West Midlands and everyone will remember fondly her eclectic Christmas quiz questions. Following an unfortunate serious injury to a senior member of the breast team, Adele took on the additional role of clinical service lead in 2008, in addition to juggling her research work, clinical activity at a time when the unit was short, and performing what she felt was her major role of being a mother. She developed the unit to reflect her approach to care and continued in this role until her death. Never one to rest on her laurels, Adele was involved in a number of other studies in breast cancer, but was also involved in the data and safety monitoring committee of a trial in oral cancer. Her involvement in the steering committees of a number of key adjuvant and neo-adjuvant chemotherapy trials helped her shape the surgical aspects of the trials and she was critical in getting patients in the current ROSCO study with known pre-treatment nodal involvement to be included in a study looking at the accuracy of sentinel node biopsy following neo-adjuvant therapy, another part of her vision that less is better when it is right. Adele's vision was to minimise the intervention that patients needed to ensure the best outcome and she was vocal in condemning the huge variation in treatment offered across the UK. As part of this she set up the NOSTRA study of post-treatment, pre-operative biopsies to establish the accuracy of this as a predictor of a complete pathological response with modern neo-adjuvant therapy. The trial that will carry her legacy forward is the LORIS (low risk ductal carcinoma in situ) study, another trial which used the bribe of a cuddly toy to engage centres with recruitment. Adele was certain that treatment of patients with ductal carcinoma in situ (DCIS) needed to be more focused and that current guidance could result in over treatment. She laid the ground work for this study over a number of years, working with the Sloane Project, which has collected data on DCIS and its outcomes as part of the screening programme for some years. Her attempts to set up a study coincided with a report on the UK screening programme by Michael Marmot, which suggested over diagnosis and consequent overtreatment in 4,000 patients a year and recommended further research. Her work in developing and establishing the study brought on board members of Independent Cancer Patients' Voice and Lesley Fallowfield, and the clear wish of patients to push this study forward supported her in getting the required funding despite the reluctance of a number of senior figures in the breast field. The study was launched in 2014 and has completed the feasibility phase, and the main trial, which aims to recruit 900 patients, is running. Her influence internationally has resulted in a number of other countries offering to support LORIS or establish similar trials. In addition, the LORIS trial was pivotal in securing a £15 million Cancer Research UK grand challenge award to an international consortium intending to identify the key biological processes determining the transition of DCIS to an invasive cancer and how to distinguish those cases that will progress from those that will not. She became the lead for breast cancer research at the Royal College of Surgeons in 2013 and used this role to engage with trainees, in particular to encourage their involvement in research. This resulted in the MASDA (Mastectomy Decisions Audit) study, a national trainee-led project. In recognition of her immense work in breast cancer, she was appointed honorary professor in cancer sciences in 2016. Her involvement in medicine did not restrict her commitment to life. Married to Noel Fitzgibbon, they had two children, Marianne and Michael. Both her children were involved in choirs, her son being a chorister at Christchurch, Oxford, and she would spend many hours in church listening to them though she was not at all religious. When her son took up polo, she refreshed her loving of riding by learning herself. She was also a keen snowboarder. Adele died on 8 January 2017. She was 57. She leaves a legacy as a clinician, a researcher, a wife and a mother that few could emulate. Many have learnt from her so far, but the learning will continue after her death, a legacy few can leave.