No treatment or surgery

It's daunting prospect for you with your current chronic issues but not everyone gets fatigue from chemo or other treatment  - I didn't. Remember that no-one can make you have treatment but also that no-one can make you stay on it. Agree with the advice given about seeing what your treatment plan is, but then there is an option to give it a go and see how you handle it. A mastectomy is often simple and straightforward. I had virtually no pain, and healed quickly. Counselling may help with the anxiety and anticipation but chronic pain is chronic pain, and I can well understand your reluctance to add to your load without some guarantees, which is probably not possible. I always think some treatment is better than none, but picking and choosing, with a little bit of try it and see, may be the way to go.