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Rebecca:
I had a lumpectomy three years ago and have been fine and grateful. I did not have a small tumor, had one pos node, aggressive cells and yet feel very safe.
I recommend finding the best, most experienced and enlightened surgeons (specializing in breast cancer surgery) you can locate and consulting two or three of them. You might even want to travel to a bigger city for your surgery.
If you know you want a mast, then the decision is easy. If you're not sure, I think the surgeon is the one who knows if a lumpectomy will give you similiar odds for staying recurrence free (and the odds should be within 5% of the odds for mast for local recurrence, the same odds for life expectancy). And the surgeon may not really know until the surgery and the pathology, so you are facing more of an unknown with a lumpectomy. For me, it has been totally worth it. I don't worry, the cosmetic result is great, I have more follow up, but I don't mind.
The others are right that there are certain criteria that do make a mast necessary or a lump not cosmetically ok -- BRCA pos, unclean margins, location of tumor, extensive DCIS, etc.
If you want help finding surgeons, you might post where you live and see if women on this site have info.
Good luck
Linda
PS. I was told that pathology (having an aggressive cancer) need not effect your surgery choice.
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