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The first surgeon had slapped a photograph of her right breast onto a viewer, pointed to a spot about 5 cm long and 2.5 cm wide and told her there was a slot open the following week for a mastectomy.Basila's first reaction to her diagnosis was an animal-instinct panic that she registered as "10,000 bricks" crushing into her chest when she woke up in the morning.Thanks to advances in genomic testing and deeper insights into the biology of different kinds of breast cancer, doctors are learning that the one-size-fits-all approach isn't working.They're also learning that every woman brings with her a unique profile of biological risk--as well as a unique appetite for risk.And when she did, Hwang said this: "Well, some people are electing to do that."Basila sat back down, and as their meeting reached the hour mark, she made a choice that humans are practically hardwired not to make in the face of a cancer diagnosis: she decided to do nothing. She would start taking a drug called tamoxifen that blocks estrogen, which can fuel tumor growth, and she would enroll in a clinical trial involving active surveillance: twice-a-year visits in which she would get mammograms alternating with MRIs. Preventive Services Task Force said in 2009 that women should start mammograms at 50, not the previous guideline of 40, because there's insufficient evidence that earlier screening does more good than harm.As long as there were no worrisome changes, Basila would be spared the standard arsenal in breast-cancer treatment: surgery, radiation and chemotherapy. And if it sounds radical today, it was all but heresy back then. Before research showed that for some women with Stages 1 and 2 breast cancer, the absolute survival benefit from preventive double mastectomies is less than 1% after 20 years.

She knew she wasn't ready to have one or both of her breasts cut off.

And she wasn't sure she wanted a lumpectomy either. Shelley Hwang, then a surgeon at the University of California, San Francisco (UCSF), recommended a lumpectomy, Basila grew frustrated.

She was coat in hand and ready to walk out the door when she issued that half taunt.

"Just one more question," she kept saying, and her surgeon appeared to her to be growing weary.

She was trying to figure out what to do about her ductal carcinoma in situ (DCIS), also known as Stage 0 breast cancer, and she was already on her second opinion.