Most thyroid nodules are benign (90-95%).
The guidelines for doing a fine needle biopsy differ from place to place, but in general they usually wait until the nodule is over 2 cm (since the chance of cancer is slightly increased if it is over 2 cm, from about 10% if it is under 2 cm to 15% if it is over 2 cm).
Hypoechoic nodules also have an increased risk of cancer, but by no means does a hypoechoic nodule on an ultrasound mean you have cancer. That's why they need to do the fine needle biopsy.
Other factors that could make it more suspicious are rough margins, taller than wide, calcifications, and vascularity. Since your nodule has smooth margins, is not taller than wide, and there was no note of calcifications or blood vessel infiltrations, the only thing that makes it "more suspicious" is the hypoechoic characteristic.
I'm not expert on this, but when I had my ultrasound, my hypoechoic nodule (similar to yours, mine was 1.3 cm, smooth margins, no vascularity or calcifications) had a chance of about 25% of being cancer based on my ultrasound report.
I know waiting for the biopsy can be terrifying, but please know that odds are still low that the nodule is cancer. If it does end up being cancer, thyroid cancer is often very treatable, and most thyroid cancers are very slow growing.
My nodule did end up being cancerous, but my situation is different from yours. I had a multinodular goiter due to chronic untreated Hashimoto's, which left my whole thyroid full of nodules and a few of many ended up being cancerous. I had to have my thyroid removed, but luckily I didn't need any further treatment for the cancer because it had not spread past the thyroid.
In my case, my biopsy of the suspicious nodule came back as "Suspicious for neoplasm", and I had it sent off for genetic testing and it still came back "suspicious, 50% risk", so when I had my surgery there was still a chance that it was not cancerous (it ended up being cancer, but by then was out of my body and no further treatment was needed, so it is still weird for me to think of it as cancer).
Good luck with your biopsy - I hope all goes well for you.
Curious how old you might be. Only reason I ask is that I have read that there is some research that thyroid cancer may be better left untreated as the “cure” is worse than the disease. Basically it is so slow that the vast majority of people leaving it alone is the better option. The older a person is, the more odds are to leave it alone.
Every case case is unique and you have to discuss with dr the best options.
Get the Biopsy. And if negative then no more to worry about really. Unless the size of the nodule causes physical discomfort and trouble swallowing etc.
However. This is just my opinion.
No one can tell you the likelihood of your nodule being cancer because everyone is different. As Sarah said, the fact that your nodule is not taller than wide, has smooth margins, doesn't appear to have blood flow or calcifications is in your favor.
It's always hard waiting for something, like the FNA, but we're here to talk to while you wait. Have you been tested for Hashimoto's yet, even though you don't have actual thyroid problems, such as hypothyroidism?
4-6 points: moderately suspicious of malignancy.
Hello everyone, I wanted to give you an update on my FNA results. They came back as “Follicular Lesion of Undetermined Significance” (see full report below). My doctor said that there is uncertainty about how to proceed, and wants to meet in person.
I would love to know if anyone has any insights into these results. I am feeling really in the dark until I meet with the doc.
Thank you all so much!
Thyroid, Left #1, Nodule-Fine Needle Aspiration: Final Cytology Diagnosis:
FOLLICULAR LESION OF UNDETERMINED SIGNIFICANCE.
Few follicular cells mostly in microfollicles and small fragments
The specimen is limited in part by obscuring blood.
Satisfactory but of limited diagnostic value due to excessive blood.
ThyroSeq genetic testing can be performed if desired. Please call Cytology at x36805 to request. Insurance preauthorization may be required.