Getting the cancer out of your body with clear margins is the most important thing. There are many options with mastectomy. Depending on the tumor location a nipple sparing could be possible with immediate reconstruction with implants or autologous or a combination. You can also have both breasts removed and reconstruction to have symmetry or have the other breast modified for symmetry later. A lumpectomy may leave you with an odd shape, it depends on how much tissue they take and how you heal. Also if you need radiation that will compromise the skin for later surgeries.
I had invasive ductal carcinoma and I opted for lumpectomy, chemo and radiation. If I could go back in time, I would have the bilateral mastectomy and reconstruction with implants. I went against the recommended big surgery because it scared me at the time. My surgeon is still recommending we go back and do the bilateral but now they have to graft from my back muscle (lat) and possibly can’t save the left nipple. I had residual cancer show up on my PET scan and that’s why she wants to go back and remove all the breast tissue.
Way your options carefully and talk to your surgeons and oncologist.