There is no difference in recurrence rates or survival between women who have a mastectomy for breast cancer and those who have breast conservation (which is a lumpectomy followed by radiation). This is only true if a patient having a lumpectomy has radiation treatment afterward; otherwise the risk of recurrence is much higher. So if a woman chooses to keep her breast and not have a mastectomy, the trade-off is that she needs to have radiation treatment. There are a few situations in which a mastectomy is absolutely necessary–for example, a woman with more than one tumor in different areas of the same breast, or with a very large tumor, or a patient who cannot tolerate radiation treatments would not be a candidate for breast conservation. In the vast majority of breast cancer patients, however, there is no difference in outcomes whether one has mastectomy or lumpectomy, and the choice is really a personal one.