Situation
A lady who smokes 20/day for the last 25 years with previous breast cancer
now presents 18 months later with a pulmonary nodule. What do you do ?
The basic question is whether this is a primary or secondary tumour. A needle biopsy would help to resolve this. It is important to get the staging for her breast cancer. Breast cancer patients can have skeletal micrometastasis that are asymptomatic, so a bone scan should be arranged, and also a CT head.
If the biopsy is unhelpful options include:
1. Just take it out, but warn patient that it may be secondary.
2. Wait 3 months and re CT scan ? with HRCT, if it is breast numerous other metastasis may have now developed.