Small breast tumor: how much treatment is "enough"

I would recommend getting a second opinion. There's very little downside and if they are in agreement, you and your friend have a lot of peace of mind. Maybe you'll find our article on getting a second opinion for cancer diagnosis helpful.

Doctors are not infallible and are usually making value judgements about risk. In my opinion, a good doctor will layout several options with all their pros and cons, make a recommendation, and allow you to make a decision.

It sounds like your friend is still waiting to find out some important information from the pathology report, which will help a lot with making decisions about prognosis and treatment.

The reason I say this is that the pathology report should tell her important things like the tumor's stage and grade, whether she is HER2/neu-positive or negative, and her estrogen receptor status. These are all important factors she and her oncologist will use to decide about lumpectomy vs. mastectomy, and in making decisions about radiation, chemotherapy, and hormone therapy. (Sometimes after a lumpectomy, the pathology report will reveal that the surgeon was not able to remove the whole tumor and will recommend a mastectomy.)

Communication is really important when it comes to treating a disease as complex as cancer, and it sounds like your friend needs to have a more in-depth talk with her oncologist so she has a chance to ask questions about her treatment options. She might find our article listing the top 20 questions to ask your oncologist helpful.