Minerva

A survey from Sydney finds that women with breast cancer are often confused about their prognosis, probably because cancer specialists overestimate patients' understanding of risk (Medical Journal of Australia 1999;171:290-4). Over half the sample—many of whom were well educated—did not understand the concept of risk reduction; three quarters did not know the meaning of “median survival”; and a third believed that doctors could predict an individual patient's outcome.

Thalidomide is enjoying a comeback in Europe as a treatment for various inflammatory dermatoses, but American doctors have been more cautious, despite the FDA's endorsement of the drug for leprosy. One US series includes only seven cases (Archives of Dermatology 1999;135:1079-87). All the patients had cutaneous lupus erythematosus, and six of them improved dramatically with a low dose of thalidomide. Thalidomide's nasty side effects, including peripheral neuropathy, are well known and presumably account for American doctors' reluctance to use it.

Women who carry mutations of BRCA1 and BRCA2 and who have had conserving surgery for breast cancer run a high risk of developing a second primary tumour in the same breast, a team of oncologists has found (Journal of Clinical Oncology 1999;17:1-8). If the finding is confirmed in larger prospective studies, oncologists and surgeons may have to think …