It is interesing that last year my numbers read the same. I have been having an annual test and examination since I turned 50. I am now going on 76. I have had numbers reading in the 6 range and fluxuating downward over the years. Last year I visited my Urologist with the PSA reading in the 4.3 range. He was unconcerned about the number and did a rectal examination also. This year my reading was 3.2 after 13 months interval. He did the exam as usual and pronounced a very health prostate gland. This is what I would do, GET A SECOND OPINION. Additionally I do not take any form of medication eg Saw Palmetto which is good for the prostate of course, but I think I would rather have my tests without it. Some doctors do things off the cuff, additionally a biopsy is usually done after some other tests. Perhaps the Doctor has his reasons for recommending a biopsy, I don't know. I still would feel comfortable with a second opinion and go from there. In any case do it in a timely fashion.