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a mastectomy does not remove ALL breast tissue so it does not guarantee 100% cancer won't come back...just may lower your risk more
mastectomies were the only choice women had years ago, but research has shown lumpectomy w/ radiation is just as effective as a mastectomy now in some cases (may not be applicable in your case)
if you are still nervous about your surgeon's recommendation, please DO NOT hesitate to get a 2nd and even 3rd opinion...the choice is ultimately yours so be informed as much as possible...good luck!!