Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
unclear of my cancer odds...
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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unclear of my cancer odds...

I am a 24-year old female recently introduced to the thyroid world...  All bloodwork has been normal, including antibodies, TSH, FT3 and FT4.  My nodule went from nothing in March, to 7.3mm on June 7th, to 7.8mm on June 18th.  The nodule does have blood flow, so a biopsy was performed yesterday.  He had to do the complete procedure TWICE because the first time he wasn't able to extract any cells.  He was concerned and said this is usually attributed to a nodule that has been there a while, but mine was non-existent 3 months ago.  He says this rapid growth and "hardening" of the nodule increase my risk of cancer (but of course still low).  

2-3 week wait on the biopsy results... My anxiety and irritability levels have increased DRAMATICALLY over the last few months, along with fatigue and sweats (the symptoms that led me on this journey) so I'm just freaking out a bit :/  

I don't know where I stand as far as odds for malignancy, my doctor wasn't very clear when I asked.  What is your clinical experience with the above mentioned concerns (blood flow, rapid growth, hardening, normal blood work, etc)?  I know my pathologist is a reputable one at MD Anderson who specializes in the thyroid, so I know I am in good hands there, I just don't know what to expect based on the above.

Thank you so much for taking the time to share your expertise. - Lindsey
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97953_tn?1193367871
Just b/c something was not documented/reported on the previous ultrasound does not mean it was not there.....Also, 7.4mm to 7.8mm is not a clinically relevant change and should be interpeted as stable.  In addition - one cannot determine if a nodule is "hard" on ultrasound w/o elastography (which is in its infancy in thyroid nodule evaluation).  So, unless you have a high-risk history (radiation exposure or family history of thyroid cancer) this nodule should be observed and considered for FNA only after growing to above 1cm -- unless ultrasound shows evidence of abnormal lymph nodes in the neck or other suspicious features).

The non-satisfactory FNA is not surprising for a small, vascular nodule -- would not interpret this as "being there a long time."

Hope that is helpful -- good luck with the pre-med / medschool  process
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1336567_tn?1291789948
Sorry, forgot to include the results of my US:

In March at a Pre-Med student meeting, an informal US of my thyroid revealed a small ("1-2mm") cyst on one lobe of my thyroid.  I got an official US on the 7th, revealing 5 nodules in my left lobe: a .3cm complex cyst, a 1cm dominant hypoechoic solid mass (with blood flow), a .7cm hypoechoic nodule, and 2 small cysts of .3 and .4cm.  
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1336567_tn?1291789948
I think when he was referring to "hard," he was saying that when the needles were being removed from the nodule after aspiration, there was more resistance/tugging than he normally feels (and boy did I feel it too!).  My concern about the growth was that it had occurred after only 10 or so days, but may still be non-significant.

There is a possibility that my maternal grandmother was diagnosed with thyroid cancer the week before she died (of other health problems) so we are investigating that to see if there is any family history.

At this point I just need to be patient for the FNA results.  Thank you so much for your insight!
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97953_tn?1193367871
Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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