Our Summary

This research paper analyzes the effectiveness and risks of surgical lung biopsy in children with cancer. The study looked at the medical records of children who underwent this procedure between 2004 and 2013. It found that this invasive procedure only led to a change in treatment in about 66% of the cases. Most of these biopsies were done to diagnose a new lump or to differentiate between an infection and metastases - the spread of cancer from one part of the body to another.

The study further found that biopsies performed to guide antibiotic treatment had lower success rates and higher risks. Children undergoing these biopsies were more likely to have a fever before the operation, more likely to be already admitted to the hospital, and had a lower count of a type of white blood cell called neutrophils. These patients also had higher death rates and major complication rates after the operation.

In conclusion, the paper suggests that doctors should carefully consider the potential benefits and risks before deciding to perform a lung biopsy in children with cancer, especially when it’s done to guide antibiotic treatment.

FAQs

  1. What is the purpose of performing a surgical lung biopsy in children with cancer?
  2. What are the potential risks of performing a lung biopsy to guide antibiotic treatment in children with cancer?
  3. What percentage of surgical lung biopsies led to a change in treatment for children with cancer between 2004 and 2013?

Doctor’s Tip

One helpful tip a doctor might give a patient about lung biopsy is to make sure to follow all pre-operative instructions provided by the medical team. This may include fasting before the procedure, stopping certain medications, and informing the medical team about any allergies or medical conditions. It is also important to discuss any concerns or questions with the doctor beforehand to ensure a clear understanding of the procedure, potential risks, and expected outcomes. Additionally, it is crucial to follow post-operative care instructions to promote healing and reduce the risk of complications.

Suitable For

Patients who are typically recommended for a lung biopsy include those with:

  1. Suspicious or abnormal lung nodules or masses seen on imaging studies such as X-rays or CT scans
  2. Persistent or unexplained respiratory symptoms such as coughing, shortness of breath, or chest pain
  3. Lung infections that are not responding to typical treatments
  4. Suspicion of lung cancer or other lung diseases such as interstitial lung disease or pulmonary fibrosis
  5. Monitoring for the progression or recurrence of lung cancer or other lung diseases
  6. Evaluation of the extent of metastasis in patients with known cancer
  7. Evaluation of the cause of abnormal lung function tests
  8. Assessment of the response to treatment in patients with lung diseases

It is important for healthcare providers to carefully evaluate each patient’s individual situation and consider the potential benefits and risks of a lung biopsy before recommending the procedure.

Timeline

Before lung biopsy:

  1. Patient presents with symptoms such as coughing, chest pain, shortness of breath, or abnormal lung imaging findings.
  2. Doctor recommends a lung biopsy to diagnose a suspected lung condition, such as cancer or infection.
  3. Patient undergoes pre-operative tests and evaluations to assess their overall health and suitability for the procedure.

After lung biopsy:

  1. Patient undergoes the surgical procedure to obtain a tissue sample from the lung.
  2. Post-operatively, the patient is monitored for any complications, such as bleeding, infection, or pneumothorax (collapsed lung).
  3. Pathology results from the biopsy are reviewed to determine the underlying cause of the lung condition.
  4. Treatment plan is adjusted based on the biopsy results, which may include surgery, chemotherapy, radiation therapy, or antibiotics.
  5. Patient undergoes follow-up appointments and imaging studies to monitor their response to treatment and disease progression.

What to Ask Your Doctor

  1. What is the purpose of the lung biopsy in my specific case?
  2. What are the potential risks and complications associated with a lung biopsy?
  3. What is the success rate of obtaining a diagnosis or changing treatment based on the results of the lung biopsy?
  4. Are there alternative diagnostic procedures or imaging tests that could provide similar information without the need for a biopsy?
  5. How will the biopsy be performed and what is the recovery process like?
  6. Will I need to stay in the hospital after the biopsy?
  7. What are the potential long-term effects or complications of the biopsy procedure?
  8. How soon will I receive the results of the biopsy and what will be the next steps in my treatment plan?
  9. Are there any specific precautions or recommendations I should follow before or after the biopsy procedure?
  10. Are there any specific factors about my health or medical history that could impact the risks or benefits of a lung biopsy in my case?

Reference

Authors: Acker SN, Gonzales D, Ross JT, Dishop MK, Deterding RR, Partrick DA. Journal: J Pediatr Surg. 2015 Sep;50(9):1490-2. doi: 10.1016/j.jpedsurg.2015.03.064. Epub 2015 Apr 25. PMID: 25957864