I was in the same predicament as you. The second go around I choice prophylactic bilateral mastectomy and immediate reconstruction. I do not regret this decision. It also reduced my probability or cancer recurrence.

I would just have the lumpectomy, and if you have no cancer showing I would do nothing else,

The only input I have is this....when I was dx all I wanted was to have the cancer gone and the damn thing removed. Once this was done it was found that I had many lymph nodes involved. You must go with your gut. Once you have radiation, and they find more breast cancer in same breast your only choice then is a mastectomy. After I had my first recon done, it was no problem. But once breast was radiated and I had to have further work done on breast it didn't heal well, I got infections and a whole list of issues. Everything with my recon is fine now. But it was about six years of problems. Radiation makes your skin less playable and it takes longer to heal, etc. Again. Go with your gut. I would never have done my any other way!! Good luck! Lynn

I am going through radiation right now. While it isnt fun I am actually doing much getter than expected (I have very fair sensitive skin and so far so good.)
Have you had a consultation with a plastic surgeon? I was able to have reconstruction and reduction with my lumpectomy and it was all covered by my HMO insurance. The plastic surgeon and surgical onc operated at the same time. I am very happy with my surgery results.

There are so many factors at play when choosing your next steps. This was one of the hardest decisions I have ever made in my life. I still look back and wonder what if I chose differently. For me lumpectomy with radiation was the best choice because of several factors in my specific diagnosis. Just remember its okay to ask lots of questions, to get second opinions, and to seek knowledge and advice. You will kake the right choice and you wont let yourself down