Women who take active roles in their decisions feel the best about their choices later on. Other factors become more important in the elderly and medically fragile. The risks of anesthesia and complications from surgery are much greater. It is also likely that she will die of another disease before she would die of breast cancer. For these reasons, a less aggressive approach is sometimes used.
Local anesthesia means that the person is awake during surgery.
The area of the lump is numbed during the surgery and the woman is given medications to relax her as well. After surgery the woman is placed on Tamoxifan and followed closely. Some women choose to have surgical reconstruction of their breasts, others do not. It, too, is matter of personal choice. In making her decision, a woman should consider her appearance both with and without clothes, since most people will see her clothed.