Hashimoto's, thyroid nodules and incidence of cancer

[Babs16]

Hi Dr. Lupo,

I am 46 years old and was diagnosed with Hashimoto's thyroiditis in Nov 2006. I have been on synthroid 0.05mg since Nov 2006  and my last TSH was 2.98, six months prior it was 1.1

I have also had two ultrasounds of my thyroid--the first was 8 mos ago--the results indicated an 8mm focal soft tissue nodule--hypoechogenic--in the left upper pole and a 6mm focal area of calcification in the lower midpole of the right lobe.  On the right side of my neck there is a normal appearing 2.3cm x 0.4cm x 1.1 cm lymph node.    Both lobes demonstrate increased vascularity and are normal to slightly large in size.  

A follow-up US was done in May 2006-- "Thyroid gland is normal in size and slightly heterogeneous.  A 6 mm calcified nodule is present in the right midpolar region and a 10 x 8 x 5 mm hypoechoic nodule is present in the left upper pole laterally.

My question:  Should I have a biopsy (?FNA) of the larger nodule or just repeat the US at regular intervals?  Does Hashimoto's predispose an individual to cancer?  And should I being seeing an endocrinologist--my family Dr. doesn't feel it is necessary.

Thanks.

[azbkyb]

A related discussion, Ultra Sound was started.

[Mark Lupo, M.D.]

Hashimoto's does appear to increase cancer rates, but most of these are still benign.  FNA would be helpful to confirm this is just an area of inflammation and not anything suspicious.

[serendipitynyc]

It probably depends on whether you are in a high risk group for cancer.

I have symptoms that are very similar to yours, meaning that my thyroid is enlarged on one side.  It also increased in size between my first and second scans (taken 4 motnhs apart).  However, my thyroid levels are apparently normal.

From what I understand, gender, genetic predisposition and age play a large role.  Women get thyroid cancer 3 times more often than men.  I read somewhere that women in their childbearing years, or at menopause are also at a greater risk.