HI Jane
These are hard decisions. They will vary from person to person. I had a mastectomy - no real choice it was that or a partial mastectomy and I couldn't see the point of part of a breast!
No suggestion of a bilateral mastectomy (then or now). I have checked given a colleague who elected to have the other breast removed, just in case, and my oncologist can see no reason to do so. However there was no heightened gene risk, and I have no history of cancer at all in my family.Like many, I stand a higher chance (not particularly high, just average!) of getting cancer somewhere else rather than my right breast.
I did not fancy a reconstruction at the time and still don't three and half years later. My surgery was all excellent, quick healing, no pain, no movement limitations (can happen, usually short term,) but I did have a problem with fluid and, short story, am not in a rush for more surgery. I was 67 when I had my mastectomy but as concerned about my looks as any. It's a large scar (large boobs!) but I don't mind it, my husband certainly doesn't, and once I got fitted with a good prosthetic, I have been fine.
Best of luck with whatever decision you make.