"Tissue is the issue"
I have yet to see any of my radiologists differentiate a lung nodule that was actually a metastasis from the colon (which can easily miss on PET ) from primary adenocarcinoma/small cell/etc. Neither a pancreatic neuroendocrine tumor from an adenocarcinoma based on a CT or PET.
I have (and often) see my patients incidentally discover masses on imaging. Perfect example- a pancreatic mass on imaging. Next stop is an anxiety filled few weeks while they wait for their biopsy to be scheduled. You then have an additional radiation exposure as these are CT guided. You hope the radiologist doesn't poke a hole in a nearby vessel, induce pancreatitis just by doing the biopsy itself, nor develop a subsequent infection related to the procedure. They then wait an additional week for pathology to result, often only to see normal pancreatic cells indicating this is a cyst.
All of this is often the result of looking for a seemingly innocent diagnosis. Eg an ultrasound to reassure your patient that their abdominal pain is not their gallbladder.
I had a similar event earlier today with a cervical lymph node seen on an ultrasound. Thyroid nodules, renal masses, lung nodules. How long do you have?
If I do the biopsy and they don't find cancer or something, they'll just tell me to drink less and eat better. Seems like mostly downside to doing the biopsy.
It's not, sounds like you're not familiar at all with all of this.
There's some road to cover from imaging -> biopsy. Blood tests, more detailed imaging, keeping an eye on it for some time, etc...
Have you heard of Pap tests? A lot of them come out find signs which could be indicative of a developing cervical cancer. Do all these women get their cervix removed the next week? No, not at all. Most of the time the symptoms go away in a few weeks. Still, pap tests are done for a reason.
Pap tests are the single thing that completely obliterates the "screening everyone is bad" argument.