Do all patients need to have a biopsy of the lung before surgery?

Do all patients need to have a biopsy of the lung before surgery?

Jay M. Lee (Surgical Director, Thoracic Oncology Program, UCLA) gives expert video advice on: How is lung cancer diagnosed?; What are some common non-surgical procedures used to diagnose lung cancer?; Can waiting for a lung cancer diagnosis cause a dangerous delay in treatment? and more...

Not all patients need to have a biopsy or a diagnosis of lung cancer before having surgery. In other words, needle biopsies can be falsely negative. In some reports, as high as twenty to thirty percent of needle biopsies can be negative. This has to do with the number of technical reasons and the size of your lung nodule or mass. As a result, even if you get a negative diagnosis, a negative biopsy result, it doesn't mean necessarily that you don't have cancer. So in patients who are relatively early stage, and this is a clinical stage determined radiographically with the use of a number of radiologic studies. And if you're an acceptable candidate for surgery, with low comoridities, and the appearance of your lung nodule or mass is very suspicious that this may be lung cancer, then in those situations it's very reasonable to proceed directly to surgery without having a biopsy or a diagnosis to say that you have lung cancer.