The safest would be to skip reconstruction. In the end, that is what I chose to do, for a number of reasons. I did bilateral with no reconstruction, and, to be honest, I quite love being flat.
One thing to consider is symmetry. Her left breast will "age" differently than the reconstructed right....
My impression *(and it's impression only)* is that the trans with tummy tuck would be more comfortable long term... but harder recovery short term. The tissue expanders, I am told, are quite uncomfortable, and it's six months before the exchange surgery... at least.
Wow - decision by MONDAY? That seems so fast... Will she need chemo? Is it possible to do chemo and then surgery? That would give her time to make the decision but would not delay the start of her treatment...
I'm so sorry she has this diagnosis - what a stressful thing - to have to make this decision with so little time.
My heart goes out to you all.