Unusual tumor and questions re approach to surgery

I have had weird pain in my arm pit and outer breast margin for years and at my last mammogram asked for a diagnostic study. The results were ambiguous but not alarming, so carried on until this past summer when the pain ratcheted up a notch. Long story short, got another mammogram, and US, followed by more mammograms and then a US guided core needle biopsy this week. Am lucky that a very experienced pathologist was consulted because it appears to be a rare type of cancer. I had actually gone to the cancer center with the goal of simply arranging surgery, but they politely explained that was not how it was done .

So the diagnosis is papillary carcinoma. I haven't seen the report, have few details, but the surgeon wants to do a sentinel node biopsy and lumpectomy. What comes after that I am not clear. And they are offering the choice of a radioactive seed or a wire. For some reason the concept of the wire bothers me much more than a seed... But I would really appreciate any thoughts on having one versus the other.

My other question involves lumpectomy. I am getting way ahead of myself, but from what little I can find on this cancer it appears that treatment protocols vary widely. If it is invasive, and my lesion is suspicious for that, I have given thought to having a bilateral simple mastectomy that spares skin and nipple. I definitely want the lesion out due to pain although I realize that may not solve the problem. I am thinking, given my extremely dense breasts, and some other factors, that rather than use my chits so to speak (chemo and radiation) at a nebulous stage, I would take a surgical approach. There is a ton of cancer in my family and weird cancers abound. I am now enrolled in a couple of studies and will be getting genetic counseling. I meet with the surgeon in a couple weeks. Will she think me crazy if I want a bi-lateral mastectomy instead of a lumpectomy? Or does one have to follow the other?

BTW--the core needle biopsy was not painful or uncomfortable thanks to the skill of the doctors and technicians that presided over it... And my tolerance for pain in that breast is just about zero right now. Any pressure makes it hurt like crazy. Plus the lesion is quite deep, in an awkward position, and fairly close to my chest wall. I explained my concerns (I had reduced pain tolerance, was worried about accidental puncture of my lungs, etc.) and the folks doing the biopsy took plenty of time to numb the area, position me comfortably, and then proceeded very efficiently. They also stopped mid way to introduce additional numbing medication which made a huge difference since I tend to metabolize things like lidocaine at the speed of light. I mention this for anyone who is facing this procedure. I did NOT want to have a core biopsy--just the word "core" summons up painful imagery--and would have done a runner had I known ahead of time this was going to happen.

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