Can doctors diagnose lung cancer with a chest x-ray?

Doctors cannot diagnose early lung cancer with a chest x-ray. A chest x-ray has low sensitivity for detecting early lung cancers when they are treatable. Chest x-rays can diagnose more advanced lung cancers.

Dr. William D. Bolton, MD
Cardiothoracic Surgeon

A chest x-ray (CXR) cannot diagnose lung cancer. However, it can identify a lung mass that needs to be evaluated and could be found to be lung cancer.

If an abnormality is identified in the CXR, the patient should see either a Thoracic surgeon or a pulmonologist for a chest CAT scan and possibly a biopsy.

A biopsy can be guided by CAT scan or bronchoscopy.

For a CAT scan guided biopsy, the patient is given local anesthetic and a physician inserts a needle through the chest into the mass.

With a bronchoscope, the physician can see inside the trachea, search for masses, and take tissue samples (biopsies).

If no diagnosis is obtained with either CAT scan or bronchoscopy guided biopsy techniques, then the patient may need to go to surgery for removal of the mass.

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Not exactly. The changes that doctors can see on a chest x-ray (such a shadow or spot) can indicate a high probability of lung cancer but sometimes such changes can be caused by benign processes such as infection or scar. Once a suspicious change is found, further tests are indicated, usually including a computed tomography scan (known as a chest CT scan) to get a better look at the abnormality. A definite diagnosis of cancer can only be made when a biopsy is performed and a piece of the mass is removed and examined under the microscope.

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