DCIS, planning for BMX and reconstruction

For some reason, I feel like I have to keep explaining my train of thought to people regarding this decision. It's not that people aren't supportive or understanding, it's honestly that I think I'm trying to convince myself. So I want to leave it all here in case it helps someone else or in case anyone has any words of wisdom to help me feel better about my decision. I guess I worry that I'm overreacting and subjecting myself to a longer recovery time and more complications for no good reason.

Even before meeting with the breast surgeon, oncologist and plastic surgeon, I was strongly leaning towards at least unilateral mastectomy--mostly due to strong family history (both sides), and fear of radiation and tamoxifen. The breast surgeon and oncologist both recommended lumpectomy, but the plastic surgeon said that because my area of DCIS is 8 cm long, she recommended mastectomy. But why do I want to do both? I'm only 42 and I don't want to have to worry about every mammogram I get for the rest of my life. I've already basically been expecting to get breast cancer and mammograms were already pretty anxiety producing. I'm also not crazy about the idea of taking Tamoxifen for a number of reasons--and my oncologist said no need to take it if I have BMX. Plus symmetry and smaller breasts are important to me. I'm not attached to the breasts I have now. They are large and pendulous, and honestly a little too sensitive, especially the week before my cycle.

Both the breast surgeon and plastic surgeon were reassuring regarding my financial concerns. Specifically the breast surgeon said they could get BMX approved by my insurance because of my family history. The plastic surgeon told me about the federal law that ensures symmetry after breast cancer treatment. But I still don't really know the details of what has been approved or what I'm paying out of pocket.

I will be having an MRI to take a closer look at both breasts prior to the surgery to make sure there is nothing suspicious in the other breast--if there is, they'll do sentinel node biopsy on that side as well and send the breast tissue for more detailed pathology.