Just wondering what peoples thoughts are on getting a bi-opsy of thyroid nodules.
I have a nodule and apparently it can be safely observed as it falls within the TIRADS (Thyroid Imaging Reporting and Data System) score of 3. However, I don’t sit comfortably with this and can’t just sit back and get an ultrasound every 1,2,3 and 5 years as per the guidlines. I’m not sure I have faith anymore (because of the events that unfolded with COVID) in the radiologist reading the scan correctly. I’m concerned they may miss something.
I have read so many negative things about bi-opsy and if cancerous can spread throughout the body. What are your suggestions?
Hi Kate, I’m just now retiring, but have been a General surgeon hope 36 years and performed over 500 thyroid surgeries. Without knowing all the details, it’s difficult to characterize what the appearance is on ultrasound. However, the guidelines are set up to be ultra conservative, so it’s not unreasonable at all just to track it over time. Generally, unless a nodule is seen to grow to 1 cm or greater, then a biopsy is not necessary.
I understand your fear (especially in light of all the lying that went on during Covid!!), but the truth is, thyroid cancer is not (usually) a rapidly growing entity. If you’re concerned, and they recommended an u/s in a year, ask for six months. Cancer will grow, nodules that remain unchanged are a good thing.
The one factor that MIGHT trigger an earlier evaluation would be longer term use of a GLP-1 med as medullary carcinoma of the thyroid can be associated. 85+% of all thyroid cancers are the much slower growing follicular and papillary types. Don’t let fear be a driving force in determining your own care. Just keep doing your own research!!
My newest endocrinologist shared the guidelines with me when she took over my care after having a lapse in coverage when my first endocrinologist retired. I had already had a biopsy when nodules were noted and I was discovered to be hypothyroid with Hashimotos during infertility work up. Biopsy was negative. I had to fight to get reestablished with endocrinology after my Dr retired. My chiropractor noticed growth in my biggest nodule and my primary finally gave in and ordered ultrasound even though she couldn’t feel it. There was growth noted of course and they urgently got me in. My young endocrinologist did a biopsy after her own ultrasound also noted the dangerous calcification that ups the score. Biopsy negative. She still pushed hard for me to consider removal or at least partial. I declined. I think I have had two more biopsies with her and the last one was painful because of that calcification. We are doing ultrasounds yearly now. When I noticed sudden growth a few years ago again, I looked to functional med resources and checked my urine iodine, started selenium and did food sensitivity testing and also had another ultrasound. Eggs and chicken were very severe for me and this included a complement test to verify these were causing inflammation. 3 weeks after changes I noticed shrinking which once again was documented with a new ultrasound. If you have looked at the scoring and agree- I wouldn’t be pushing for biopsy just because. The Thyroid Pharmacist on facebook is a functional medicine trained pharmacist who has Hashimotos herself. There is a wealth of knowledge and resources on her website and page.
That’s why the forums are here. It’s a win win.