What should I do about a thyroid nodule?

November 01, 2013

By Gabriela Sanchez, MD

Thyroid nodules are extremely common and studies have shown that about half of us have at least one!

Fortunately, most of these nodules do not pose any health risks. Not all thyroid nodules are benign, however, and in a minority of cases (about 5-15%) may contain a cancer. The challenge, of course, is figuring out which nodules are cause for concern and which ones are not.

With increased use of high-resolution imaging, more nodules are being identified today than ever before. It is also not uncommon for someone to learn they have a nodule “incidentally” after a CT scan, MRI or ultrasound that was performed for some other medical reason.

If you think you may have a thyroid nodule, or if one has been found incidentally by medical imaging, you should make an appointment to see your doctor. Your doctor will likely take several steps, including:

  • A careful examination of your thyroid gland.
  • Ordering basic thyroid hormone lab tests to make sure your thyroid gland is working normally.
  • Ordering a dedicated ultrasound study of your neck to examine the thyroid gland. The ultrasound is a painless and radiation-free imaging tool that can evaluate the shape, size, location and consistency of thyroid nodules, as well as other characteristics important in deciding whether any further tests are needed.

Depending on your exam and the features of the nodule seen on ultrasound, your doctor may then recommend that you undergo a small biopsy, called a “fine needle aspiration.” This simple procedure is performed in an outpatient setting with the patient awake, and because it uses a very thin needle, causes only minimal discomfort. A sample of cells is taken from the nodule and sent to a pathologist who will examine the cells for any signs of cancer or other abnormality. While the fine needle aspiration biopsy is a great tool, it is not perfect. Because it samples only a small amount of tissue, sometimes the results are “indeterminate” and the test has to be repeated.

To summarize, the good news about thyroid nodules is that although they are very common, thyroid cancer is not. The vast majority of thyroid nodules are inconsequential and will cause no harm. Even if thyroid cancer is identified, the treatment for most types of thyroid cancer is usually extremely effective and cure rates are very high. As with any cancer, the earlier it is identified the better the outcome. Therefore, if you think you have a thyroid nodule go ahead and have it evaluated!