Minimally invasive follicular thyroid cancer is not aggressive and the prognosis is generally excellent.. Completion thyroidectomy is the norm and I-131 would not likely be needed in most cases. Levothyroxine alone is standard of care w/ a small subgroup of hypo patients who may benefit from the addtiion of liothyronine but this would not be started initially (ie, re-evaluate at 3-6 months w/ TSH and symptom review)
Agree - current guidelines treat all FCs w/ I-131.
This will likely become more selective in 2013 guidelines (due in Fall).
Most large series on min inv FC are very reassuring - surgery alone should be curative, but some would still give 30mCi (mininal risk of side-effects/secondary cancers) to be more comfortable.
Talk to your doctor about I-131 vs observation.
Thank you Dr Lupo.
According to ATA 2009 recommendation, they recommend I-131 for my case (recommendation 32) due to my tumor size.
In your opinion, what circumstances of minimally invasive FC warrants I-131? The side effects are quite scary. Leukemia risk increases by 2.5 fold in younger patients although no age was mentioned. In addition, secondar malignancy was a concern as well with its use.