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- Thyroid nodules are very common. Most are benign (not cancerous).
- Less than 5% of thyroid nodules in adults are cancerous. In children, 20% to 30% of thyroid nodules are proven to be cancerous.
- Thyroid cancer is usually painless and without symptoms in its early stages.
- Unless there is an obvious neck mass that can be seen, most nodules are detected by chance during a routine physical examination or during a doctor visit for an unrelated purpose.
- Some symptoms that may appear include:
- Hoarseness that has no known cause and does not go away
- Difficulty breathing or shortness of breath
- Difficulty swallowing or an unusual sensation (a “lump”) when swallowing
- Nodule (lump) or growth in the neck
- An abnormally large lymph node (a “swollen gland”) that fails to spontaneously shrink over a few months' time
Steps in evaluating a thyroid nodule may include:
- Physical examination. This should include a laryngeal exam (checking the vocal cords).
- Neck ultrasound
- Fine needle aspiration (FNA) biopsy, often under ultrasound guidance
- Thyroid function lab tests—blood tests
- Chest X-ray
- CT (computerized tomography) without iodine contrast—or other imaging techniques
- Thyroid scan with low-dose radioactive iodine or technetium
- Other blood testing involving molecular markers, for patients with indeterminate thyroid nodules
Points to keep in mind:
- Your doctor will determine the diagnostic tools to use for you. Don’t hesitate to ask questions about the merits of each tool.
- The fine needle aspiration (FNA) is the most reliable way to determine whether a nodule is benign, definitely cancerous, or possibly cancerous.
- The FNA cannot always determine whether cancer is definitely present. In this situation, the tissue analysis after thyroid surgery is used to determine the diagnosis.
Last updated: May 19, 2013