1step, as promised here's a bit of a mastectomy ramble for you.
So when I was diagnosed, they advised mastectomy, which was kind of helpful as it meant I didn't have the dilemma of choice. We're all so different, so I'd say just get as many facts from your team as you can, then decide after that. If you decide to go for a Mastectomy, the good news is that you imagine it would hurt lots, but they don't. The main pain is from nerve damage and the scar, but it's honestly not too bad. I'd imagine the amount of pain is about the same as a lumpectomy in lots of ways.
Do you know if you're having nodes taken? That's more painful and problematic as you can get swelling and also a lot of nerve pain - you also have to work quite hard to maintain your mobility.
My op meant just an overnight in hospital. That does seem to depend on where you live though/ your surgeon's take on it all. The annoying part is you have surgical drains to the wound (think sports bottles with tubes for fluid to drain into). They're a bit yuk and can stay in for a while - depends how much your body's draining. They take them out once it's below a certain level. My hospital are happy for you to come home with them in. Others aren't.
On reconstruction, they probably won't do it if you're having radiation. Having said that, they might consider an implant, as that's what I was offered. I wasn't going to but both BCN and Surgeon thought it a good idea - their take was why wouldn't you, as it gives you some shape, so in some ways makes the mastectomy potentially less traumatic. My Surgeon also thought it might help with radiation as it kept the skin stretched. I have no idea if that's true or not, as other surgeons seem to think differently.
Pluses for implant: you have no nipple and a huge scar, but you do still have a breast shape, which is potentially less of a shock. Also means no fussing with prosthesis and clothes hang okay. I went for it because they advised it, but also because I thought it might be easier for DS as it didn't look so drastic.
Minuses for implant: whatever they do your new breast won't match the other. Obviously with no implant it's just no breast, but an implant though it gives shape, won't match - it will be harder and perkier (!).
If you went for an implant they'd probably give you one like mine, so an expander implant. It's half silicone and half saline - they put the saline in a few weeks after the op to give your body time to recover. They inject the saline in through a port which sits under the skin. They actually call it 'pumping you up', which always makes me laugh as it's so low tech. I was a bit unlucky with mine as it flipped, so sat very high up. It was never especially comfortable either as very tight and hard, but the Surgeon thought she'd guesstimated wrong and put one in that was too big.
If you do have rads, they almost always have to switch the implant afterwards, so that means another op. I've had mine switched to silicone at the same time as the preventative mastectomy last Oct and it's fab - feels much nicer than the expander one and the shape's good too. They're going to do the switch to silicone just after Easter, so just over two years on from diagnosis I might finally have matching breasts again. Not a big op, and hopefully my final one.
The curious thing about all of this is that I have basically had a boob job on the NHS. My Surgeon says she'll just keep going until I'm happy. She's a wondrous woman, who is approachable and clearly very good so I'm incredibly lucky. I was given a good piece of advice by my BCN, who said you need a qualified Plastic Surgeon - not all Breast Surgeons have had that training, so beware and ask lots of questions. BCN are brilliant for that - if you haven't the courage to ask the surgeon, you can usually get the BCN to give you an honest view, or get her to see if any other women your surgeon has operated on will talk to you. That helps a lot too.
Long, long post. Hope some of this helps. Ask any and all questions, but in the end you decide what's right for you. We're all so different and everyone of us have different breast cancer too. Whatever you decide, you will be fine. Repeat on a loop for sanity, but it's true! 