What to do next? Painful lump; ultrasound, mammo and mri show nothing helpful

I discovered a tiny (maybe 0.5 cm wide) palpable lump under my right nipple in October (it was not there for sure the previous June when I had a screening mammo). You can only find it while in a standing position. If you push hard it hurts quite a lot. It is otherwise painless and not noticeable.

A repeat mammo in November showed no changes (benign calcifications forming no pattern - same on both sides). An ultra sound showed nothing at all. I saw a breast specialist in December. With my help, he was also able to locate the lump with his finger. He attempted a needle biopsy right there in the office. The results were inconclusive (tissue sample was too small), and he and I both think he likely missed it.

I qualified for a screening MRI due to family history (my mom was diagnosed with pre-menopausal breast cancer at 38, and passed away from it at 45... no other family relatives with cancer). The MRI showed no evidence of cancer.

At my follow-up visit today the conclusion was that the lump appeared to be roughly the same size. I have been losing weight, so I think that is why it is now a little biy easier to feel (I've lost a whole cup size and am down to 129 pounds). He made a new attempt to do the needle biopsy, and this one hurt way more than the last one (only while he was getting it... nothing much afterward). I am hoping that it might mean he got something this time, but maybe that is wishful thinking.

If this biopsy shows nothing his suggestion is to wait another 2-3 months and perform another follow-up. If it is still there my only choices are:
(1) continue appointments every 2-3 months to monitor
(2) surgical biopsy which will produce a noticable divot under the nipple

His feeling is the it is very likely not cancer, but the only way to tell with certainty is option #2...

What should I do??? Any suggestions/advice would be most appreciated... :)

[japdip]

With your family history I would choose option #2 without hesitation. Weigh the slight divot beneath the nipple against your concern of "not knowing" .... I'm voting for the divot which would bring peace of mind. Needle biopsies are all too often not sufficient for a diagnosis and scars fade with time. This of course is all dependant upon the biopsy results. Regards ....