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TIRAD 4 and worried about thyroid cancer

Posted by andreag @andreag, Nov 18, 2023

I'm not even sure this is the right group for me because it's not confirmed i have Thyroid cancer - but i'm not sure where else to post. Anyway, i had a neck ultrasound done about a week ago for an unrelated issue and an incidental finding was several nodules on my thyroid, so it was recommended i have another ultrasound of just my thyroid. I got those results back this morning - 4 nodules total, two on each lobe, 1 solid one on each lobe and a colloidal cyst on each lobe, only one of the solid ones was described as "concerning" and i was given TIRAD of 4 - it is 1.1 cm x 1.1 cm x 1 cm - the recommendation is to wait a year and do another ultrasound. I know that a TIRAD of 4 means that there were some features that are concerning for malignancy. I do understand that most thyroid cancers are slow growing and metastasis may be rare, so i guess that's why they are ok waiting a year? MY understanding is that if my nodule was 1.5 cm instead of 1.1, i'd be getting a biopsy. I have an appointment with my doctor on tuesday. Is it reasonable to ask for a second opinion? I should also note that I have type 2 diabetes and i'm being monitored for a breast lesion that was BIRAD of 3 - i also was adopted so i don't know all of my family history. I'm just wondering if i should ask my doctor to be referred to an endocrinologist? I think if i spoke to a specialist who is familiar with these types of things and aware of my risk factors, i'd feel better waiting a year if they agreed with that recommendation. Thoughts? I know Thyroid cancer is very treatable but i don't like the thought of something that is potentially malignant staying in my body for a year. thanks

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Moderator
Colleen Young, Connect Director | @colleenyoung | Nov 22, 2023
In reply to @andreag "well honestly my doctor seemed kind of annoyed with me. He said "well, we typically don't..." + (show)
@andreag

well honestly my doctor seemed kind of annoyed with me. He said "well, we typically don't worry about nodules that are 1cm or less" and i acknowledged that and told him that it was the TIRAD 4 rating that had me concerned, so he kind of abruptly cut me off and said "ok i'll refer you to an ENT for a biopsy." told me i should hear about when my appt is from his office sometime in the next two weeks or so and then he hung up. Normally i have a very good relationship with him and i agree with him that i don't know if a biopsy is absolutely necessary but i do need a second opinion. So we will see how it goes.

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Andrea, the sqeaky wheel gets the grease. I'm glad you got an appointment for a biopsy. If I'm reading your messages correctly, you have not been diagnosed or had treatment for breast cancer, correct? Have you ever had radiation?

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1 reply
andreag | @andreag | Nov 22, 2023
In reply to @colleenyoung "Andrea, the sqeaky wheel gets the grease. I'm glad you got an appointment for a biopsy...." + (show)
@colleenyoung

Andrea, the sqeaky wheel gets the grease. I'm glad you got an appointment for a biopsy. If I'm reading your messages correctly, you have not been diagnosed or had treatment for breast cancer, correct? Have you ever had radiation?

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Hi there- yes you are correct. I had a suspicious mammogram and ultrasound of my left breast in June of 2023 - was immediately referred to a specialist and that work up ended up ok- BIRADS 3 so probably benign but I go back for that follow up in February

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mama2:6 | @msmarissa7 | Apr 8 5:00pm

Hello,
I’m so sorry you had to go through all of this!
It’s so scary just being told might be benign is not enough for me. It’s unbearable to be on edge for 6-12 for waiting for another exam.
I am literally in the same situation you were in last year. Not knowing what to do.
I was diagnosed with nodules, I have had thyroid issues for years now but I’m in remission it is categorized TR 4 . My biggest nodule is considered borderline it is 1.5 cm.
I found a breast lump that was birads 3.
I was told to wait 6 months. For another ultrasound on both. My paternal and maternal grandmother had previously had breast cancer and my maternal had thyroid cancer. I just want answers.
I hope you are doing better. Did you end up getting additional support or a second opinion? I just am not sure where I should go with this.

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1 reply
andreag | @andreag | Apr 9 5:32am
In reply to @msmarissa7 "Hello, I’m so sorry you had to go through all of this! It’s so scary just..." + (show)
@msmarissa7

Hello,
I’m so sorry you had to go through all of this!
It’s so scary just being told might be benign is not enough for me. It’s unbearable to be on edge for 6-12 for waiting for another exam.
I am literally in the same situation you were in last year. Not knowing what to do.
I was diagnosed with nodules, I have had thyroid issues for years now but I’m in remission it is categorized TR 4 . My biggest nodule is considered borderline it is 1.5 cm.
I found a breast lump that was birads 3.
I was told to wait 6 months. For another ultrasound on both. My paternal and maternal grandmother had previously had breast cancer and my maternal had thyroid cancer. I just want answers.
I hope you are doing better. Did you end up getting additional support or a second opinion? I just am not sure where I should go with this.

Jump to this post

Hi there - i did see the ENT on March 6. He opted to wait until september to do another ultrasound and see if it's grown at all - he felt that at 1.1 cm it was slightly too small to do a biopsy - he apparently does it by feeling with his hand and it's not an ultrasound guided biopsy (not sure how i feel about that) but i felt ok waiting until September. I wish you luck on you journey - are you going to seek a second opinion? Waiting is so hard - on one hand i get it - thyroid cancer is very treatable and rarely spreads (most types anyway) so it's probably ok to wait but i dislike how nonchalant some docs are with this..i mean cancer is cancer and it's scary - i do understand that i think their attitude is supposed to be reassuring but to most people it doesn't seem to be,

REPLY
2 replies
mama2:6 | @msmarissa7 | Apr 9 12:19pm
In reply to @andreag "Hi there - i did see the ENT on March 6. He opted to wait until..." + (show)
@andreag

Hi there - i did see the ENT on March 6. He opted to wait until september to do another ultrasound and see if it's grown at all - he felt that at 1.1 cm it was slightly too small to do a biopsy - he apparently does it by feeling with his hand and it's not an ultrasound guided biopsy (not sure how i feel about that) but i felt ok waiting until September. I wish you luck on you journey - are you going to seek a second opinion? Waiting is so hard - on one hand i get it - thyroid cancer is very treatable and rarely spreads (most types anyway) so it's probably ok to wait but i dislike how nonchalant some docs are with this..i mean cancer is cancer and it's scary - i do understand that i think their attitude is supposed to be reassuring but to most people it doesn't seem to be,

Jump to this post

Good morning.
I’m thinking of seeing a specialist to look into it a bit more. I was told my largest is 1.5 cm .Also I don’t want the specialist to be dismissive but it seems this way almost everytime with providers these days. The thing that has been so concerning for me is my hair loss. I’m losing soo much hair it’s depressing.
I am sure everything is okay I think I just want some peace of mind. I think we all would like that. I was so surprised to come across your post! Our situations are very similar.

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1 reply
andreag | @andreag | Apr 9 3:34pm
In reply to @msmarissa7 "Good morning. I’m thinking of seeing a specialist to look into it a bit more. I..." + (show)
@msmarissa7

Good morning.
I’m thinking of seeing a specialist to look into it a bit more. I was told my largest is 1.5 cm .Also I don’t want the specialist to be dismissive but it seems this way almost everytime with providers these days. The thing that has been so concerning for me is my hair loss. I’m losing soo much hair it’s depressing.
I am sure everything is okay I think I just want some peace of mind. I think we all would like that. I was so surprised to come across your post! Our situations are very similar.

Jump to this post

There are a lot of us out there! Being or feeling dismissed by medical professionals. Did they test your hormone levels? If you also have hair loss I’m wondering if you should see and endocrinologist

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1 reply
mama2:6 | @msmarissa7 | Apr 9 5:37pm
In reply to @andreag "There are a lot of us out there! Being or feeling dismissed by medical professionals. Did..." + (show)
@andreag

There are a lot of us out there! Being or feeling dismissed by medical professionals. Did they test your hormone levels? If you also have hair loss I’m wondering if you should see and endocrinologist

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I did just have an appointment with my endo, who said my thyroid levels are normal. I’m in remission with hyperthyroidism. He said 6 months we will do another ultrasound on my neck.

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sgp55 | @sgp55 | Jul 13 10:39am
In reply to @andreag "Hi there - i did see the ENT on March 6. He opted to wait until..." + (show)
@andreag

Hi there - i did see the ENT on March 6. He opted to wait until september to do another ultrasound and see if it's grown at all - he felt that at 1.1 cm it was slightly too small to do a biopsy - he apparently does it by feeling with his hand and it's not an ultrasound guided biopsy (not sure how i feel about that) but i felt ok waiting until September. I wish you luck on you journey - are you going to seek a second opinion? Waiting is so hard - on one hand i get it - thyroid cancer is very treatable and rarely spreads (most types anyway) so it's probably ok to wait but i dislike how nonchalant some docs are with this..i mean cancer is cancer and it's scary - i do understand that i think their attitude is supposed to be reassuring but to most people it doesn't seem to be,

Jump to this post

I have a small TIRADS 5 nodule that they have been monitoring with ultrasound for about 5 years. It is 1.1 cm now and I have a biopsy scheduled in 2 weeks with my Endocrinologist. He still thinks it might be to small to biopsy but I want to have more information if possible. I had a previous ultrasound guided biopsy of a TIRADS 3 nodule several years ago which was benign. I don't think I would want a biopsy that relied just on what the doctor feels with his hand. My doctor is also very dismissive and I don't really like him much.

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koh | @koh | Jul 14 7:01am

I never heard of FNA without ultrasound guiding the process….. maybe it’s time for a second opinion. If the dr does the FNA and it’s negative, you will question the findings since he didn’t use ultrasound…. Might be better to just change doctors now and see what they think. Good luck!

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fossfactor | @fossfactor | Jul 14 5:02pm

I agree I have somewhat monitored a nodule for ten years and this year it had grown to 13 mm and the other one was 9mm. The larger one was mistakenly read at 17mm so I had a biopsy which showed papillary carcinoma which was a bit scary. The endocrinologist and my cancer doctor at Mayo were outstanding as well as the nursing staff. I had two nodules on the left side and Dr. Stuckey removed half of my thyroid. I am waiting for the biopsies to come back. I have read that there is a two percent chance of spreading so I am feeling confident.
The biopsy was not too bad and the surgery just feels like I got throat punched. I am on day four after surgery and feeling well. I am glad they did get it out. Just hoping I don't have to take iodine if any spread has occurred.
The surgery staff were simply amazing. I cannot recommend Mayo enough. Good luck.

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