What is a thyroid nodule?

Thyroid nodules are very common, occurring in up to 40% of adults. They are small lumps that form within the thyroid gland.

I have a thyroid nodule. Is it likely to cause me any problems?

Thyroid nodules can cause problems in 3 main ways:

1. They can produce too much thyroid hormone, causing hyperthyroidism. This is usually suspected based on blood tests.

2. If they are large, they may push on nearby structures, such as the esophagus or the nerves that control the vocal cords. Let your doctor know if you have difficulty breathing or swallowing, or hoarseness.

3. Rarely, thyroid nodules can represent a thyroid cancer. A biopsy can help make the diagnosis.

My doctor wants to do a thyroid biopsy. Why?

  1. Biopsy is usually recommended for thyroid nodules that are larger than 1 cm, in order to rule out the possibility of thyroid cancer.
  2. Thyroid biopsy, also called a fine needle aspiration, is an outpatient procedure with minimal risks. You should not take blood thinners or aspirin for 5 days before the biopsy.

I have a thyroid nodule. Is it likely to cause me any problems?

Thyroid nodules can cause problems in 3 main ways:

1. They can produce too much thyroid hormone, causing hyperthyroidism. This is usually suspected based on blood tests.

2. If they are large, they may push on nearby structures, such as the esophagus or the nerves that control the vocal cords. Let your doctor know if you have difficulty breathing or swallowing, or hoarseness.

3. Rarely, thyroid nodules can represent a thyroid cancer. A biopsy can help make the diagnosis.

How is a thyroid biopsy done?

  1. An ultrasound is used to guide the needle into the nodule being biopsied.
  2. A small needle is inserted into the nodule, and a small amount of material is removed and placed onto a microscope slide.
  3. There is a 10-20% chance of getting insufficient cells on the slide. Therefore, your doctor will typically do 3-4 sticks per nodule.
  4. After the biopsy is done, you will be able to eat, drive, and go about your usual activities.
  5. Results are usually back within 10 days. It is preferable to give results in person rather than by phone.

My biopsy came back suspicious for thyroid cancer. What happens next?

Depending on the type of cancer, the size of the cancer, and your other clinical history, your doctor will discuss your individualized treatment plan with you. Treatment for thyroid cancer usually starts with surgical removal of the thyroid, followed by radioactive iodine ablation. Thyroid cancers are usually slow-growing tumors, and most patients respond very well to treatment. However, it is important to continue surveillance annually to look for thyroid cancer recurrence, which can sometimes occur years or even decades after the original treatment.