Lung Nodules: Biopsy and Treatment

Biopsy

If a pulmonary nodule is considered highly suspicious for lung cancer, it will need to be biopsied to determine if it is cancerous. This will be based on its size, shape and appearance on chest X-ray or CT scan, as well as considering other risk factors. Those could be your smoking history and family history of cancer. The biopsy is a simple procedure of getting a sample from the pulmonary nodule for microscopic exam. It can be done surgically, through a bronchoscope or by placing a needle through the chest wall under radiographic guidance.

The bronchoscope approach is an outpatient procedure without any cutting, sutures or sticking needles through the chest wall. After heavy sedation and numbing of mouth and throat, the bronchoscope is inserted into your airway and is guided to the lung nodule. A sample is taken and immediately examined by a pathologist (a doctor who identifies diseases by studying cells and tissue under a microscope).

The pathologist will determine if the pulmonary nodule is cancerous or benign. If it is benign (not cancerous), your doctor will ask you to come back in the future to re-examine the spot with another X-ray. Your doctor will watch the nodule for any changes and catch it early if it becomes cancerous. If the nodule is cancerous, a few more samples will be taken or other tests performed to determine if the cancer has spread. Then your doctor will discuss next steps with you.

Treatment

Benign (non-cancerous) lung nodules do not need treatment. Lung cancer, if localized, is usually removed surgically. If part of the cancer has spread to other parts of the body, you may need chemotherapy, radiation therapy, surgery, alone or in various combinations.