Question: Hello,

I'm a 67 yr old male who quit smoking 30 years ago after 34 pack years. Ive been in a LDCT program since 2012 and have a history of 8 nodules 1-4mm and the rest less than 4mm that are either stable(2+ yrs) or no longer present. Yesterday I had a screen that showed the following:
"Major airways patent. There is no focal consolidation, pleural effusion, or pneumothorax. Linear atelectasis is identified in the medial segment of the left lower lobe. biapical pleural scarring is noted. Nrw nodularity in the anterior aspects of the left lower lobe is noted measuring 2 mm. This may represent a small vessel. Oblong 4 mm nodule in the lateral aspect is unchanged. 2 mm nodules in the right lower lobe were not previously seen. A new 4 mm nodule is identified in the lateral aspect of the left upper lobe. Subtle tree-in-bud and groundglass nodularity is identified in the medial aspect ofv the left upper lobe. This is more apparent versus the comparison study.(June 2017, Feb 2018). Additional new nodules in the mid aspect of the left lower lobe and tree-in-bud nodularity is noted. these nodules measure 2-3 mm. New 3 mm nodule identified in the left lower lobe.
Impression: New bilateral pulmonary nodules measuring up to 4 mm. Scattered areas od tree-in-bud nodularity are also new in interval. The findings may reflect inflammatory changes. Thes nodules are categorized as lung RADS cat 3, probably benign. 6 mo follow-up ldct for surveillance recommended.
I have had 2 squamous cell scalp cancers in past 10 yrs. There is no family history of lung cancer or emphysema. I haven't had a upper respiratory infection this year and am in otherwise good health. The radiologist said my 4 mm was solid and not spiculated. I'm trying to estimate my lung cancer risk. I,ve looked at various lung nodule calculators that indicate my risk is .2% to 10% for the 4 mm nodule. Also read "LUNG CANCER RISK ASSOCIATED WITH NEW SOLID NODULES IN THE NLST(Natl Lung Scr Tr). which indicated an interval 1.1% risk for the 7 smaller nodules and 2.3% risk for the 4 mm. Simply put-(1.1% x 7) plus 2.3%=10% risk. Do you think I'm over or undersestimating my risk? Can you give me an an estimate of my risk? I really don't know if I'm at 2.3% or 10% or ??? Also which of the risk calculators should be used? XXXXXXX Mayo, none of the above???
Thanks for all your help.

Thanks for your response. What is it about my report that makes you think my nodule(s) are benign? And should I be concerned about the implications of actelasis and new nodules in my lower left lobe? Any specifics are appreciated. I'm comfortable with most medical jargon. Thanks again!

And if I'm overestimating risk, what is my risk approximately?

Thanks very much!