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BMJ 2005; 330 doi: (Published 02 June 2005) Cite this as: BMJ 2005;330:1338

Given plenty of information, fewer than 20% of women eligible to take tamoxifen to reduce the risk of breast cancer and who perceived themselves to be at very high risk of the disease decided to take the drug. Researchers interviewed 250 women about their attitudes towards taking tamoxifen and found a mean self perceived five year risk of breast cancer of 32.7%. Women with very high perceived risk were no more likely to choose tamoxifen than those with the lowest perceived risk, and adverse side effects were the main reason for declining it (Cancer 2005;103: 1996-2005

Conducting “talking therapy” at arm's length is meaningless, says a writer in the South African Medical Journal (2005;95: 318-20). If we keep the desk between ourselves and the patient, the best we can offer is listening with “one ear.” It's like the matador in the ring needing to feel the breath of the bull on his face. Anything less is instantly picked up by the crowd, and people will jeer and throw things into the ring.

Abnormal metabolism could explain the finding of vascular disease in people who don't smoke and who don't have raised cholesterol concentrations. Animal studies have shown that overexpression of a gene involved in producing energy from respiratory oxygen in …

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