Hi, DSB. With your family history, I would think you WOULD be able to find a surgeon who would do a prophylactic double mastectomy, and I would think your insurance would cover it. This is obviously not a cosmetic surgery, and there is reason to believe that this might significantly reduce your chances of getting breast cancer in the future, which would save the insurance company $$$. Hysterectomies to avoid future problems are pretty commonplace; if you think about it, the mastectomies would be no different, really. OF course, it depends on whether you have really good insurance (thank goodness if you do!), or really bad insurance (which is becoming more and more common, unfortunately!).
I don't think a needle biopsy will make any cancer that you might have spread. But I would agree with you that a surgical biopsy would be a better choice. Remove the suspicious area altogether.
Another note: a double mastectomy will go a long way in alleviating your risk of breast cancer, that is true. But it doesn't entirely eliminate it. No matter how good the surgeon, it is impossible to remove every breast tissue cell, and those remaining cells could still develop breast cancer. Of course, your odds of that happening are very slim, but you still need to be vigilant about examining the breast area and have your gyn check you every year, as well.
Good luck in your quest to find the right surgeon. A good breast center would be the place to start, I would think.
"There's a difference between a philosophy and a bumper sticker." --Charles Schulz