Can a Bronchoscopy Detect Cancer?

Why do we need a bronchoscopy?

Bronchoscopy helps doctors find out what is causing a problem in your lungs. Reasons for doing a bronchoscopy include:

• Take a lung tissue biopsy 
• Diagnose a lung infection 
• Stent placement 
• Removal of an airway blockage 
• Treatment of a lung condition 

How does a bronchoscopy work?

This procedure is done using a flexible bronchoscope that is usually about half an inch wide and at least two feet long. It has a camera at the end to allow the doctor to see inside the lungs. It also has a tube that allows for the passage of small instruments or fluids. Special devices like a biopsy instrument, a cauterizing tool to stop bleeding, or even a laser to shrink tumors may be introduced to the lungs using the bronchoscope. When the scope is in the proper location, samples may be collected.  Some of the procedures done using the bronchoscope include:

• Brush biopsy — a small brush is transferred into the airway via the scope to collect cells from the airway wall.
• Transbronchial biopsy  — a small forceps is transferred into the lung through the scope, and lung tissue samples are collected.
• Bronchoalveolar lavage — a saline solution is placed into the scope and the lung and then suctioned out after the airway is “flushed.”
• Transbronchial needle aspiration — a small needle is passed into the bronchoscope and into the bronchial wall to sample tissue. 

Any collected samples are sent to the lab for diagnostic testing.  

Can cancer be detected with bronchoscopy?

A bronchoscopy is often used to look at abnormal areas seen on tests such as an x-ray or CT scan. If there are any abnormal areas detected, the bronchoscope can be used to collect a biopsy sample the labs can test for cancer. 

In addition to testing with a bronchoscope, those suspected of having cancer may also have an additional ultrasound probe to check the lymph nodes of the chest. This procedure, called endobronchial ultrasound  (EBUS), assists doctors in choosing the proper treatment.  An EBUS can also see if cancer has spread. 

The EBUS equipment is passed down the airway and pointed in various directions to look at lymph nodes and other structures. The microphone-like tip  — called a transducer  — passes sound waves and picks up echos bouncing off structures.  The echoes are converted into an image on a computer screen. If the area is suspected of being cancerous, transbronchial needle aspiration can then be performed. 

An EBUS is usually done via flexible bronchoscopy because it is non-invasive. But, only 69 percent of microtumors are detected when flexible bronchoscopy is done alone. Over the last twenty years, new techniques have been developed to be more specific for detecting cancer. These techniques include:

• Autofluorescence bronchoscopy (AFB) 
• Narrowband imaging (NBI) 
• High magnification bronchovideoscopy (HMB)

Tissue biopsy remains the gold standard for diagnosing cancer in the lungs. Technology involving bronchoscopy is considered the most accurate and safest way to test airway mucosa.

Are there any complications with bronchoscopy?

Though usually safe, with bronchoscopy, there is a minimal risk of:

After your procedure, your doctor may check for complications with an x-ray. If there are any problems involving your breathing, you will have to be treated.  

What should I expect after a bronchoscopy?

Afterward, you will be monitored by medical staff. Due to anesthesia, your throat and mouth may be numb for a while after the procedure. You will not be able to eat until the anesthesia wears off, to avoid aspiration or vomiting.

Mild symptoms after a bronchoscopy include: 

Things to watch out for post-bronchoscopy that may indicate something is wrong are:

These side effects are rare. But, if any of these conditions occur,  you should contact your doctor as soon as possible.