The move to double mastectomy among American women, most of whom have early-stage breast cancer, continues, particularly among young women, raising concerns that two decades of public education about the benefits of lumpectomy and radiation are getting eroded. The high rates of re-operation after a first lumpectomy are part of the reason, which some surgeons are addressing by taking slightly more tissue to avoid another operation. The issue of repeat lumpectomies is an issue top surgeons say must be addressed if medicine wants to reach more women with the message that survival of women with lumpectomy and radiation is equal to mastectomy.