Step 1: Perform a limited CT of the chest with the skin surfaces markers in place, over the planned site of entry. This also allows for assessment of the pulmonary nodule and mass and if there has been change suggestive of a benign process (e.g. infection) then biopsy may be delayed or cancelled and close follow-up performed.
You can make your own surface marker grid for these purposes - see surface marker grid for CT guided biopsy.
Proceed to insert local anaesthetic (1% lidocaine) along the route of the proposed biopsy down to and including the outer pleura.