Thank you so much for your thoughtful response. Your information and personal experience are very helpful.
I am meeting to discuss reconstruction possibilities with a plastic surgeon within the next week. A lumpectomy is possible but the success is 50/50 and the breast area impacted, while small for some people, would be larger than optimal for my size.
My preference would be to do the lumpectomy however the concern is that if this is done that it would limit reconstruction options if this didn't work. Something to talk to the plastic surgeon about I know.
This website has been so helpful. Since DCIS and ALH are either stage 0 or pre-cancerous, it has made this whole thing hard to discuss. The few people I have mentioned my diagnosis to always say "good thing you got this early" - and then go on to provide details about a friend or themselves who had a later stage cancer and went through various treatments and thankfully ended up fine and have an almost unnoticeable scar from the surgery. I then say yes, that is amazing, and then never want to mention anything to anyone again. I wonder if anyone else feels like this sometime?
I hope all goes well for you with your decision on what to do with the ALH - this must be difficult after just going through the DCIS. The what ifs are always hard. My best wishes go to you.