Does it cause harm to follow up
nodules that prove malignant?
l For cancers <3 cm, there is controversy about
whether survival is better with smaller tumor
size.
l Highly malignant tumors are likely metastasize while
still small. Survival for stage 1A tumors only 50-85%
l For less aggressive tumors, staging will not change if
biopsy or surgery is delayed for several months.
l So there may be no harm in waiting to be sure a
small nodule is growing before pursuing
aggressive dx.
l Risk of delayed diagnosis must be balanced by
risks and expense of invasive diagnostic tests or
multiple follow up CT scans.