At 73, can FNAC confirm my mom’s lung cancer?

Hello doctor,

I wanted to get your advice on an unfortunate case with my ​grandmother. She is 73 years old, has shortness of breath, has had a seven kg weight loss (post-TB medication), has no exuberant coughing or blood, has a previous history of breast cancer with chemo., she does not have the urge to eat since starting the medication, X-Rays attached.

Her history includes;

Suspicion of TB (due to a positive test and abnormality on X-ray) and a few months of treatment after that. There hasn't been much improvement on X-rays, as told by doctors. Based on her radiological findings, the physicians suspect her lung cancer. However, her biopsy is negative, speculating that the TB treatment could have interfered with the results. Doctors do not want to perform any more interventions (such as FNAC).

Her CT report is as follows:

A moderately sized, mildly enhancing hypodense mass lesion measures. approx 10 x 4.5 x 4.7 is seen in the apical-anterior segment of the right upper lobe and right middle lobe. The right upper lobe bronchus is abruptly cut-off. No obvious area of necrosis or calcification is seen with the lesion.

Volume loss of the right hemithorax is seen as evident by rib crowding and ipsilateral tracheal shift.

The lesion is extending into the mediastinum in the pre-tracheal region.

The lesion is abutting the mediastinal pleura, SVC & right branch of the pulmonary artery; however, contract enhancement is seen.

Laterally, the lesion is extending up to the hilum.

The posterior segment of the right upper lobe & right lower lobe are partially aerated.

Area of increased parenchymal density with air bronchogram lucency - consolidation with infiltrates is seen in the basal segments of the right lower lobe.

Mild right-sided pleural effusion is seen.

An enlarged lymph node is seen in the pre-tracheal region, measuring. 12.0 mm

A depressed fracture of the right-sided 5th rib is noted anteriorly, an old injury.

Please tell me,

1. What is the way to confirm the diagnosis?
2. Should another FNAC be conducted to prove the diagnosis, as only X-Ray is being used to diagnose?
3. If it is lung cancer, are there some possible options of care, as the doctors looking after her say nothing can be done?

Kindly help.