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  • Skip FNA for highly suspect nodule <1cm?

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    Old 02-11-2017, 02:52 PM   #1
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    Question Skip FNA for highly suspect nodule <1cm?

    Hi, this is my first post to the community as I am a newbie and have been scouring the web and self-educating since my thyroid disorder. Here is my brief biological workup:

    *34 year old female
    *Family history of thyroid disease
    *Family history of advanced-stages of cancer (none thyroid)
    *Diagnosed Hypothyroid approx. 2.5 years ago and started on Levo
    *Additional Hypo symptoms returning and further testing about 4 months ago revealed thyroid antibodies, resulting in diagnosis of Hashimotos
    *Approx. 2.5 months ago, noticed swelling in my lower right-side of neck, with internal neck feeling "thick, scratchy, itchy" with difficulty swallowing.
    *Additionally, I could feel a knot or something in my throat, which hurts off and on continuously.
    *Physical examination conducted by my primary MD was positive for goiter, and swollen nodes. Had to wait until after holidays to get in for thyroid ultrasound.

    I received my thyroid ultrasound results back with the following findings:

    Singular 8mm nodule in the right thyroid lobe, slightly heterogeneous, hypoechoic, containing multiple internal calcifications, and a single tiny cystic component. Internal color Doppler flow is present. Additionally, there is subtle hyperechogenicity in the upper pole of the right thyroid lobe without a discrete nodule.

    The left lobe represents normal size, echogenicity, and normal color Doppler Flow.

    Tissue sampling is suggested.

    So here is my question: Has anyone on here had experience with their Endo or ENT, where they felt that clinical findings, family history, and ultrasound were strong enough to bypass FNAB? I'm curious if doctors ever choose to go surgery route without FNAB, especially considering the smaller size of my nodule?

    I have some additional symptoms that we have been completely unsure of, which may or may not be related. After doing some initial research containing the subject "thyroid cancer with xxxx symptoms", I have stopped all research like that as I don't like what is popping up. I am not a fearful person, nor anyone who reads ailments and immediately identifies with them. Even with all the recent research and reports, I remain relatively calm, despite my husband waking me in the middle of the night a nervous wreck.

    Thanks for any comments, suggestions, or even sharing of your own experiences.

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    Old 02-12-2017, 12:15 PM   #2
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    Re: Skip FNA for highly suspect nodule <1cm?

    keep in mind, everything on the internet, leads to cancer---they want you to see your doctor. It would be up to the surgeon, with his/her experience to assist with the decision---if a surgeon was expecting cancer for sure, the surgery would be different.
    There have been many changes in thyroid cancer diagnosis in recent years, and sometimes, an encapsulated nodule, under a cm, isn't even considered cancer any more at some cancer research hospitals...
    Take your time, don't jump to conclusions, get a great surgeon to walk and talk you through this based upon research, and real world experience....
    That being said, people who have had thyroid cancer (I did many years ago), usually live long and healthy lives afterward....tell your husband all will be ok....

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    ap0019 (02-12-2017)
    Old 02-12-2017, 04:56 PM   #3
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    Re: Skip FNA for highly suspect nodule <1cm?

    Thanks for the reply and kind words.

    I do know that the nodule is not encapsulated, but after that and the other information, that is all we have at this point. My hubby gets anxious if his left arm falls asleep, and must go to the ER

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    Old 04-25-2017, 03:37 AM   #4
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    Re: Skip FNA for highly suspect nodule <1cm?

    I asked for a second opinion at a research hospital with an endocrine surgery program that was also in network for my insurance. I asked to get referred because the specialist I went to won't take you without it. That surgeon had a visit and surgery with me in almost the same time frame as waiting for the first consult with a local ENT surgeon. If I would have stayed with the ENT he wasn't able to get me in until a week or two after I had two surgeries at the large program. The ENT was also probably a good surgeon but there is no way that he has had the numbers the specialty program has. I felt the difference in care and it made me feel calm and relaxed. My hubby is like yours and half my stress has been keeping his head strait!! I got massages, try to excercise when I could. it is statistically very treatable even if you don't like your diagnosis. But, going through it sucks and I totally understand wanting to skip FNA. I can tell you from experience almost everyone I meet except my hospital staff and hubby who is a healthcare worker downplays the experience not realizing how bad this can make you feel emotionally and physically over years, then adding the wait time figuring out what everything is. because it is nerve racking! I'm sure most People mean well and they are trying to calm you because the statistics are very good and in your favor but Every bit of finding these things wrong in your body sucks!!!! My surgeon was kind enough to call me on a Friday night before my appointment to give me a heads up to have time to make a decision and plan. Those things have a big impact on how you feel about your treatment.

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    calcifications, fna, thyroid biopsy, thyroid cancer

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