The doctor may not recommend a breast lump excision or lumpectomy if you have:A large tumor and small breasts, in which case breast lump excision may lead to poor cosmetic results2 or more tumors in different quadrants of your breast that cannot be removed with a single incisionCancer that has spread throughout the breast and overlying skin, which cannot be removed by breast lump excisionNo access to radiation therapyA history of radiation treatment to the breast, which would make further radiation treatments riskyA history of scleroderma, a chronic hardening of the skin and other tissues that may make healing difficultA history of systemic lupus erythematosus, an autoimmune disease worsened by radiation treatments