Thyroid Nodules
What are thyroid nodules?
Thyroid nodules are overgrowths of tissue within the thyroid gland. Fortunately, the vast majority of thyroid nodules are benign and only a small percentage are malignant. Thyroid nodules are common within the population, with as many as 50% of people having at least one nodule by the age of 60. Most thyroid nodules are discovered incidentally, during a scan that was ordered for a separate issue. Occasionally, a thyroid nodule will be noticed by the patient, either because it is visible, or because it is causing pressure symptoms on other structures within the neck, such as the foodpipe (oesophagus) or windpipe (trachea).
Do I need surgery for thyroid nodules?
If you have been diagnosed with thyroid nodule(s) – either incidentally during a scan for a separate issue, or if you have symptoms – a full evaluation will be performed to determine whether the nodule(s) might be cancerous, overactive or causing pressure symptoms. This workup usually includes:
a blood test to check your thyroid function
a thyroid ultrasound scan
likely a biopsy of the nodule(s) (FNA, or fine needle aspiration), which is reported by means of the Bethesda classification. This classifications consists of a category between 1 and 6, with 1 being a non-diagnostic biopsy and 6 indicates the presence of a cancer.
occasionally a CT scan if the thyroid gland is significantly enlarged
occasionally a functional scan of the thyroid to check for overactive areas
Most thyroid nodules are benign and can be managed by observation, using surveillance ultrasound scans. Nodules that are indeterminate or malignant (or even overactive) will require surgery. The characteristics of the nodule(s) on imaging in combination with the FNA result and associated Bethesda score are important factors that will decide the need for surgery. Dr Bell is specialised in the surgical treatment of thyroid conditions. She will be able to explain your results with you and advise whether surgery is needed.