Typing “thyroid nodule” into Google generates more than 683,000 results. Lumps and bumps in the thyroid are exceedingly common, especially in women. By age 50, up to 70 percent of women have one or more thyroid nodules, the vast majority of these are noncancerous. In fact, of all thyroid nodules, up to 95 percent are ultimately characterized as benign.
Largely because of the increased use of radiologic imaging, the incidence of thyroid nodules, and the incidence of thyroid cancer, is increasing. Though this (possibly artificial) rise in thyroid cancer may seem alarming, the fact is that even if a nodule is cancerous, thyroid cancer is by far one of the most curable cancers. In fact, cure rates for the two most common types of thyroid cancer are in the high 90 percentile range, approaching 100 percent. The American Cancer Society estimates that of the nearly 63,000 cases of all types of thyroid cancer occurring in the U.S. each year, and fewer than 1,900 result in mortality.
Thyroid Screening and Diagnosis
Often, thyroid nodules are detected by patients themselves, or by a physician performing a routine exam. If you do feel a lump in the region of the thyroid, which is in the lower central neck, below the Adam’s apple, it is worth a trip to your doctor to get checked out. Your doctor may choose to do a screening ultrasound, or perhaps a fine needle biopsy of the nodule, which is a simple office procedure that characterizes thyroid nodules. Recent developments in genetic testing of needle aspiration material make this test even more useful in terms of guiding management of thyroid nodules.
Who is at Risk for Thyroid Disease?
If you have a family history of thyroid cancer, or had exposure to ionizing radiation through prior medical treatment or proximity to a nuclear facility, your risk of malignant thyroid disease is greater. Furthermore, though thyroid nodules are far less common in men, the likelihood of malignancy in any given nodule is greater in males. Usually, there is no specific relationship between the presence of nodules and alterations in thyroid hormone level (hyperthyroidism or hypothyroidism), so keep in mind that one problem does not generally result in the other.
For more information, please visit www.mountsinai.org/thyroid.
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Dr. Marita Teng, Associate Professor Otolaryngology at Mount Sinai Hospital, specializing in Ear, Nose, Throat/Otolaryngology.