Dr Sam Smith has made a major effort to understand the reluctance of general practitioners to recommend preventive therapy for cancer.50 His surveys have indicated that GPs are prepared to continue to prescribe preventive medicine such as tamoxifen or aromatase inhibitors to women at high risk of breast cancer, provided therapy is initiated in specialist centres and then referred to the general practitioner for continued use. This evidence concerns the gene CYP19A1 and breast carcinoma.