Multiple lung nodules: Might they be noncancerous? What next?

I am at a teaching hospital, so the doctor who ordered the CT (rheumatologist) sent me to the pulmonologist in oncology quickly when some were found. They really "hooked" me up quickly with the people I needed to see. I had one biopsy in a lymph node, which showed nothing. They wanted to do a resection, but I declined since it was just one node. Drs concurred. They thought it was perhaps from getting a recent vaccination in that arm. I am also now taking D3, which is thought to affect nodules.

My mother also died from lung cancer at age 56, in 1973. Long time smoker, had a lot of pneumonia over the last years of her life. I have MCTD, so they keep watch and the first CT showed nodules and for about a year, it was a lot of testing, including a pet scan. But the followup CT showed no growth, so waiting until Jan of 2024 to return to the oncology pulmonologist. I am glad to have someone knowledgeable who has a sense of how serious this is. I have several nodules under 5mm and one ground glass at 1.5mm. I really was worried for awhile, after Covid, but breathing is pretty good. I hope that the greater technology these days will help you out on this.

Thank you! It was my primary Dr. I’m going to ask her to refer me to a pulmonologist. But you know how mayo is..it will probably be months before I can get in. And the report stated wait 3 mos and do another ct scan..but that person doesn’t know my family history! So frustrating.

Thank you so much for the information. I truly appreciate it. I had CT for my heart..I had high cholesterol.
You stated a statistic of 95%, but that is not for nodules over 10mm. Unfortunately its much lower percentage. Everything I have read and as you stated, it should be biopsied or have a PET scan but for some reason my physicians want to wait. Even with my family history. 🤔 So if the national standard is to have the tests why are they so hesitant??

Your concern is understandable. My mother died at age 58 from lung cancer and my cousin on my mother's side at 54 of the same. You mentioned "My family physician wants to take a watch and see approach". Is that a Family Medicine or Internal Medicine doctor? If so, and your insurance allows you, seek out a Specialist (Pulmonologist). Check their background and look for one that treats lung nodules and/or lung cancer because not all of them do. Have you read the radiologist's report? Those reports can contain recommendations on follow up. I had an abnormal chest x-ray at urgent care and the report recommended a CT scan. I made an appointment directly with Pulmonologist and skipped my primary care provider- the CT scan report recommended PET scan. I did have lung cancer. My only symptom was recent shortness of breath which could also be attributed to a heart issue. I always look for a specialist for specific health issues. Medicine is a large subject, and it is important to see the knowledgeable experienced doctor with the right training.

Welcome, @aahlrichs. I can understand that you're concerned. Being told that you have a 13mm lung nodule is worrisome and you have a family experience with lung cancer. Most lung nodules (95%) aren't cancerous. Read more here: https://www.mayoclinic.org/diseases-conditions/lung-cancer/expert-answers/lung-nodules/faq-20058445

I moved your question to this existing discussion where @felix536 was asking similar questions as you are today:
- Multiple lung nodules: Might they be noncancerous? What next? https://connect.mayoclinic.org/discussion/multiple-lung-nodules/

I did this so you can read the previous helpful posts and connect easily with other members like @merpreb @sueinmn @vic83 @marye2 and others.

Often, active surveillance is the first step and a new CT scan ordered in 3 to 6 months to see if it is growing. Sometimes, with nodules over 12mm further testing such as a PET scan or biopsy will be ordered.

@aahlrichs, may I ask why the CT scan was ordered that found the nodule? Nodules rarely cause symptoms. Were you having symptoms or was the CT scan for something else?

I hope I’m in the correct area to ask this question..during a recent CT scan a 13mm nodule on my lung was found. I’ve had two close family members die of lung cancer. My family physician wants to take a watch and see approach but everything I read says “over 10mm should have PET scan or biopsied”. And that if it is malignant it can grow fast during the “watch and see” time frame. I’m curious if I have legitimate concerns??
My information at this point has only come from doctors, who see many benign cases a day, and insurance companies. The nurses and doctors at this point have all treated it like it’s not a big deal and pushed me off.
I’d really appreciate any advice. Thank you for reading. 😊

Mine was ground glass, with lacey edges and is relatively small (1 cm) so they said they could not biopsy. Waiting.

Good no solidity. Keep an eye on it and will hope that it stays stable. Hoping the best for you. Has anyone ever had "hazy opacities in lung base that could represent sequela of needle biopsy"? This showed up on a chest x-ray eleven days after the needle biopsy.

This sounds like where I am right now! My lesion was all ground glass with no solidity so I am waiting 6 more months! No biopsy will be done as I can only have SBRT (radiation) at this point because I can't lose too much more lung tissue.

I wish you well on March 8th. Do you have any preparations that you have to do or stop any medications?