When people ask me for "the biggest sacrifice" I go with Minato and Sarutobi. Just because the whole "eternity in the Shingami's stomach" thing. But they lived good lives and died knowing their village loves them.
As for Itachi, the saddest part is, imagine being 11 or 13 years old and coming up with such a plan. Knowing your whole life will be a painful facade that you would die for. I also don't think he counted on Madara knowing everything, he died probably thinking everything he wanted to protect would hate his memory. He systematically had to ruin his whole life just so he could at least hinder Madara. Then again, Kishi might rick roll us when he explains this
I've also entertained the thought that Itachi has extremist ideals similar to Pein or Danzou. But I want to believe Itachi was merely playing the part of a spy, because that truly was the best way <3
In my opinion, Minato's and Sarutobi's was the greatest sacrifice, but Itachi's seems to be the most heartbreaking. I really hope he didn't go through all of that in vain.