Supreme Court Justice Ruth Bader Ginsburg died Friday after a trailblazing legal career that started with fights for women’s rights and ended with her ascension into a liberal cultural phenomenon for her outspoken and consistent judicial approach.

Ginsburg, 87, died surrounded by her family at her home in Washington after more than 27 years on the high court. The cause was complications of metastatic pancreatic cancer, the Supreme Court announced in a news release.

Her death sets off yet another high-stakes confirmation fight in the Senate right in the middle of a heated presidential election — possibly giving President Donald Trump a third appointment to the high court in less than four years.

That would deepen a conservative tilt to the court that could bring far-reaching changes to the nation’s legal landscape in health care, immigration and civil rights. Ginsburg was a consistent voice in the liberal wing of the court.

Trump last week released a list of potential Supreme Court appointments if given another chance, including three Republican senators — Tom Cotton of Arkansas, Ted Cruz of Texas and Josh Hawley of Missouri. Mostly seen as part of his pitch to conservative voters on issues such as gun control and abortion, that list will now become key.

The inclusion of the senators, as well as conservative jurists Trump put on lower benches, signal that Trump’s next appointment would be even more conservative than his two appointments of Justices Neil M. Gorsuch and Brett M. Kavanaugh.

Supreme Court confirmation battles can take months, and Trump and Senate Republicans could press to fill it before January.

When the death of Justice Antonin Scalia left a vacancy during President Barack Obama’s last year in office, Senate Majority Leader Mitch McConnell of Kentucky and other Republicans refused to hold a confirmation hearing or vote. McConnell previously has said he would fill a vacancy this year if one arose.

“Our Nation has lost a jurist of historic stature,” Chief Justice John G. Roberts Jr. said in the news release Friday. “We at the Supreme Court have lost a cherished colleague. Today we mourn, but with confidence that future generations will remember Ruth Bader Ginsburg as we knew her — a tireless and resolute champion of justice.”

Ginsburg, born March 15, 1933, was the second female justice to serve on the Supreme Court and delivered key opinions and fiery dissents on gender discrimination, such as a 1996 opinion that opened up the Virginia Military Institute to qualified women and a 2007 dissent in a key case about equal pay for female employees.

The Brooklyn native, appointed to the Supreme Court in 1993 by President Bill Clinton, consistently sided with the liberal wing of the court in landmark cases that legalized same-sex marriage and kept abortion rights.

But with a conservative majority for that entire stretch, Ginsburg often expressed herself most forcefully in dissents about voting rights, worker rights and the contraceptive mandate of the 2010 health care law.

She became known for wearing a dissent collar on the bench on days when the court announced key decisions. She called a 5-4 majority opinion “destructive” and “egregiously wrong” in a 2018 case about public sector unions. In a dissent to a 2014 decision about the contraceptive mandate, Ginsburg wrote: “The court, I fear, has ventured into a minefield.”

That style led a blog to dub her “Notorious R.B.G,” after another Brooklyn native, gangster rapper “Notorious B.I.G.,” and other cultural salutes such as action figures and a book about her workout routine escalated along with the number of women in politics and law.

She demonstrated that workout on “The Late Show” with Stephen Colbert. A documentary simply titled “RBG” highlighted her path to the high court, and she got a cameo in a movie in Dec. 2018, “On the Basis of Sex,” about her time breaking into a legal career when men dominated the field.

Ginsburg helped launch the Women’s Rights Project of the American Civil Liberties Union, served as that group’s general counsel and on its national board of directors in the 1970s.

President Jimmy Carter appointed her to the influential U.S. Court of Appeals for the District of Columbia Circuit.

The Senate voted 96-3 to confirm her to the Supreme Court in 1993, despite some concerns from conservatives about her past work with the ACLU. At the confirmation hearings, Ginsburg endorsed abortion rights but expressed reservations about the legal reasoning behind Roe v. Wade, the 1973 landmark ruling that established a constitutional right to an abortion and fueled controversy ever since.

Ginsburg is among those justices who expressed that such a bipartisan result would not be possible in the politically polarized Congress of today.

In an October appearance, Ginsburg said that “to me, the obvious culprit is Congress,” and pointed out the lack of effort to “reach across the aisle,” the Washington Post reported. “What a difference in time that was from what we are witnessing today,” she said.

Ginsburg became more outspoken in recent years, and had to issue a rare apology for comments about Donald Trump during the 2016 presidential election. Among other statements, she called Trump a “faker” who “says whatever comes into his head at the moment,” criticized him for not releasing his tax returns, and suggested a move to New Zealand would be a proper response to a Trump presidency.

She later called those remarks “ill-advised” said she regretted making them. “Judges should avoid commenting on a candidate for public office. In the future I will be more circumspect.” Ginsburg said in a written statement distributed by the court.

Some liberal legal scholars criticized Ginsburg for not retiring when Obama was president and Democrats controlled the Senate, particularly because she had been treated for cancer in 1999 and 2009.

Those health issues had accelerated over the past two years. In December 2018, Ginsburg fell and fractured several ribs, and doctors found lung cancer that was removed surgically. In August 2019, Ginsburg underwent three weeks of radiation treatment for pancreatic cancer.

“As cancer survivors know, that dread disease is a challenge, and it helps to know that people are rooting for you. Now, it’s not universal,” Ginsburg said in New York City in September 2019, according to media accounts. But she said she would be on the job “as long as I’m healthy and mentally agile.”

On a July 2019 panel at Georgetown University, where she often appeared, a professor who studied Ginsburg’s work said that the justice’s rhetorical legacy reminded Americans that they too have a responsibility for changing the nation’s legal landscape.

Colorado State University professor Katie Gibson, said it was Ginsburg’s “sustained process of connecting legal argument to lived experience, her citation of non-legal voices as authorities, her calls for action outside of the court, activate a dialogue between the judiciary and the broader public that invites a broader range of actors to claim agency in shaping the meaning of the law.”