I didn't have my other breast removed or a reconstruction. I was 67, no history of cancer in the family let alone breast cancer and neither my oncologist or surgeon thought it was necessary. As I had a large and persistent seroma resulting in a serious infection a year after surgery, no one is particularly keen for me to go for more surgery unless there is a reason. Short story is if I get cancer again it is as likely to be elsewhere in the body as in my other breast. But it's a really personal decision, and there are no guarantees so it's important to do what feels right for you. Good luck whatever decision you make.