Nodules between 6 mm and 10 mm need to be carefully assessed. Nodules greater than 10 mm in diameter should be biopsied or removed due to the 80 percent probability that they are malignant. Nodules greater than 3 cm are referred to as lung masses.
Lung nodules are usually 5 mm to 25 mm in size, but the larger nodules (larger than 25 mm) are more likely to be cancerous than the smaller ones.
About 40 percent of pulmonary nodules turn out to be cancerous. Half of all patients treated for a cancerous pulmonary nodule live at least five years past the diagnosis. But if the nodule is one centimeter across or smaller, survival after five years rises to 80 percent. That's why early detection is critical.
A pulmonary nodule can be benign or cancerous. Lesions larger than 3 cm are considered masses and are treated as cancerous until proven otherwise. Lung nodules are quite common and are found on one in 500 chest X-rays and one in 100 CT scans of the chest.
The cancer risk is much lower in low-risk patients. The cancer risk increases in pulmonary nodules larger than 8 mm. In the NELSON study the risk of malignancy in nodules larger than 10mm was 15.2% (34).
However, your doctor may suspect a lung nodule is cancerous if it grows quickly or has ridged edges. Even if your doctor believes the nodule is benign or noncancerous, he or she may order follow-up chest scans for some time to monitor the nodule and identify any changes in size, shape or appearance.
The location of the lung nodule may guide the care team in evaluating possible risk, and studies indicate that nodules in the upper lobe may be more indicative of cancer. However, not all nodules in the upper region of the lung are cancerous, and not all nodules located elsewhere are benign.
The smaller the nodule, the more likely it is to be benign. Also, benign nodules grow very slowly, if at all, while cancerous nodules on average can double in size every four months or less.
Most lung nodules don't cause any symptoms and are often found on a chest X-ray or CT scan performed for another reason. If symptoms are present, they may include: Coughing. Coughing up blood.
Nodules between 6 mm and 10 mm need to be carefully assessed. Nodules greater than 10 mm in diameter should be biopsied or removed due to the 80 percent probability that they are malignant.
While the overall survival of the participants was 80 percent, the survival rate for the 139 participants with nonsolid cancerous lung nodules and the 155 participants with nodules that had a partly solid consistency was 100 percent. For the 991 participants with solid nodules, the survival rate was 73 percent.
Most lung nodules are benign, or non-cancerous. In fact, only 3 or 4 out of 100 lung nodules end up being cancerous, or less than five percent. But, lung nodules should always be further evaluated for cancer, even if they're small.
If >6 mm, the repeat CT at 3 to 6 months, if nodule continues to grow or has persistent solid component >6 mm, the patient is deemed high risk, and resection should be considered. A CT should be performed annually for 5 years if the nodule is unchanged from a prior and solid component <6 mm.
Benign lung nodules can be caused by inflammation from a number of conditions. They include: Bacterial infections, such as tuberculosis and pneumonia. Fungal infections, such as histoplasmosis, coccidioidomycosis or aspergillosis.
When an infection or illness inflames lung tissue, a small clump of cells (granuloma) can form. Over time, a granuloma can calcify or harden in the lung, causing a noncancerous lung nodule. A neoplasm is an abnormal growth of cells in the lung.
Benign lung nodules and tumors usually cause no symptoms. This is why they are almost always found accidentally on a chest X-ray or CT scan.
Lung biopsy procedures are not usually painful and have few risks that doctors associate with them. A doctor will only recommend a lung biopsy procedure to support their diagnosis. For example, if a person has smaller lung nodules, a biopsy may be too risky and difficult to justify.
In general, a lung nodule can be removed very safely and using a minimally invasive surgical approach. Your surgeon may want to perform a bronchoscopy to take a closer look at your nodules and take a biopsy. A biopsy involves removing a piece of your lung to look at it under a microscope.
Treatment for a cancerous nodule
A doctor may request a thoracotomy to remove a cancerous nodule. This surgical procedure involves removing the nodule through an incision in the chest wall. Additional treatments for cancerous lung nodules may include chemotherapy, radiation therapy, and other surgical interventions.
But most lung nodules aren't cancerous. Lung nodules are small clumps of cells in the lungs. They're very common. Most lung nodules are scar tissue from past lung infections.
In the vast majority of cases, lung nodules turn out to be small benign scars, indicating the site of a previous small area of infection. These nodules may be permanent or may even spontaneously disappear by the time of the next scan. Most are of absolutely no consequence.
Some nodules will be followed with a repeat CT scan in 6-12 months for a few years to make sure it does not change. If the lung nodule biopsy shows an infection, you might be sent to a specialist called an infectious disease doctor, for further testing.
Your chest may hurt and be swollen for up to 6 weeks. It may ache or feel stiff for up to 3 months. For up to 3 months, you may also feel tightness, itching, numbness, or tingling around the cut (incision) the doctor made. Your doctor will give you medicines to help with pain.
Biopsies are usually not recommended when nodules are small because it is very difficult to biopsy them safely. Doing a biopsy when a nodule is small can cause harm such as trouble breathing, bleeding, or infection. Biopsies are often done for nodules that are 9 mm or larger.