I am 44 years old and have a 4 cm right breast mass. My doctor says I need a surgical biopsy. Is this really necessary

Some patients with a large breast mass may need to undergo an open surgical biopsy. Surgical biopsy of the breast may be performed under local or general anesthesia. Surgery requires a small incision and a biopsy can be easily obtained. In the past most breast biopsies were performed using surgery but today the development of ultrasound and MRI has led to demise of surgery to obtain biopsies. Perhaps you can ask your doctor about a needle biopsy first. 

It is highly recommended that any women with an unknown breast mass undergo some type of breast biopsy procedure to confirm the identity of the lesion.