Ultrasound = TR5; biopsy/surgery questions

Posted by ekh3 @ekh3, Feb 21, 2023

Hello Thyroid Group! This is my fist post. I had an incidental discovery of a 1cm nodule in a carotid artery ultrasound after an episode of severe vertigo. Thyroid ultrasound revealed a TiRad of 5 (#9), wider than tall. I am referred for a biopsy which I will have in two days. I have already found a surgeon and talked with her, and am planning to have the lobe removed even if biopsy comes back benign. My questions are: is biopsy even necessary since I know I will be having the surgery anyway? What is the recovery like after the lobectomy? Will I be able to fly cross-country 3-4 days after the lobectomy? The surgeon has told me no strenuous exercise for two weeks, and 'laying low' for the first week. Also, will I not know until after surgery and pathology report if I will need the radioactive iodine treatment? Thank you, all. I am grateful this community exists and I send positive healing warmth to you all!

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koh | @koh | Feb 22, 2023

Hi, I don’t understand why anyone would want to have thyroid surgery unless it is necessary. There is a procedure called radio frequency ablation to shrink nodules that might be beneficial if your testing does not support a suspicion of malignancy. RFA might be able to shrink the nodule so it goes away.
FYI- A lobectomy does not always result in the other lobe producing enough TSH and you end up having to get regulated on Synthroid… something that is not as easy as people think.
I am surprised that a surgeon spoke with you about removing an organ before identifying a need to remove the organ; but I think surgery should always be the last option.
Good luck!

Colleen Young, Connect Director | @colleenyoung | Feb 25, 2023

@ekh3, how did the biopsy go? Did you get the results back yet?

ekh3 | @ekh3 | Feb 26, 2023

Hello Colleen, thank you for your thoughtful follow-up. It warmed me to see your question when I haven’t even told all my daughters this yet, so am feeling like I’m sitting with it a bit too much on my own. I had five biopsies last Thursday, and results are expected Tues through Thurs this week. The doctor doing the biopsies said she needed to do so many to ensure an accurate reading. But ouch I wasn’t expecting more than one deep needle! She also said she’ll send me a list of surgeons in CA where I live. But I’m wondering if I should go to my friend who specializes in this surgery at MGH. I need to understand recovery needs and weigh pros/cons. Biopsy doctor said survival rate is 90% if stage one, which was somber news for me. Thank you for checking in and for this group’s reassurance.

ekh3 | @ekh3 | Feb 26, 2023

In reply to @koh "Hi, I don’t understand why anyone would want to have thyroid surgery unless it is necessary...." + (show)

Thank you for this, @koh! Yes I generally agree. Surgical inclination was based on the high rating based on ultrasound appearance, and upon hearing that the nodule would likely grow rather than remain as is. So the thinking was to remove that risk. Good to hear about RFA, I’m eager to learn more about that and see if it’s an option in my case. Also I’d like to learn more about synthroid. My sister had a lobe removed over a decade ago and has been fine w remains lobe and her kelp supplements. But I know every case is different. Thank you!

Colleen Young, Connect Director | @colleenyoung | Mar 4, 2023

In reply to @ekh3 "Hello Colleen, thank you for your thoughtful follow-up. It warmed me to see your question when..." + (show)

@ekh3, ouch. I don't think I would've expected multiple biopsies either. Did you get the results and speak with doctor?

ekh3 | @ekh3 | Mar 18, 2023

I did, and doctor and I were surprised to see it was benign. She said 5% chance that’s a false negative, but she did get four ‘good’ slides of the five, so feels I should wait six months and repeat rather than going to surgeon. Obviously relieved with result, but odd bc I was set on having it removed. Concerned about its nasty appearance on ultrasound but MD says slow growing. Said surgery has equal risk (5%) of permanently damaging voice and possible breathing problems. Do you all here agree to do nothing now but wait?

koh | @koh | Mar 19, 2023

That sounds like good news and a good plan… if you are uncomfortable with it you can always ask about shortening the time period for repeating the FNA.
Did they do the Affirma testing on any of the slides? They seem to have a high degree of accuracy for predicting cancer. As long as the nodule isn’t causing any issues with its size or location it seems like it’s fine to wait…. but I always think that surgery is always the last option.
Good luck!