It is a hard decision, I honestly couldn't have made a decision for a Mastectomy it just wasn't something I ever wanted. When I had a recurrence however, I didn't want to tempt fate again, the Genetic Counselors were really good, they said the odds of me getting anything in the other breast is as the normal population as its separate. Hardest thing is all we have is what is here in front of us right now and where we've been in order to make a good decision. Having had my mastectomy/diep flap recon now, it wasn't nearly as psychological as I thought and I guess as the Diep flap is using my tummy fat and flap, so its all still me. I didnt want an implant and lucky I guess I couldnt have one as Id had radiation.
I think I just learned that I had to make a decision that I could live with nobody else, and know I'd done enough for me and what I was comfortable with. It's so incredibly personal, so I say trust yourself, whats your gut feeling because that will be your best start.
xxMelinda