Thyroid nodule biopsy

Posted by memada32 @memada32, Dec 28, 2022

Hi! I am 40 y.o. and recently diagnosed with multiple thyroid nodules and family doctor is recommending biopsy. Has anyone found good research on the risks of biopsy to spread cancer? Also, how was your personal experience with this kind of biopsy? Thanks in advance! Trying to get as much info before making a decision.

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My 38 year old Son went through similar, turned out to be metastatic carcinoma. Has since had thyroid remoted and will begin radiation treatment soon. Wishing you all the best.

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Hi,
From what I understand, thyroid nodules are fairly common. I don’t know if having multiple nodules is an indicator of a problem or just a regular part of aging. From what I understand, nodules can come and go without people even knowing they were there. However, if the nodules are large or growing they could signal a problem….not necessarily cancer, just a problem because they can start to impact the structures in the area.
In my opinion, you might want to go to an endocrinologist to assess the situation. If the nodules are very small, they would be hard to biopsy and I was told it is usually not done. If the nodules are large it is good to have a biopsy however, biopsies are not always conclusive, so they can do other testing,
In my opinion, the biopsy does not hurt; some were a little uncomfortable, however they really didn’t hurt. The biopsy seems to be used as a predictor for possible cancer and used to help make decisions.
As for cancer spreading from the biopsy….. I was told I did not qualify for Radiofrequency ablation to shrink a large nodule because the cells had a 50% chance of Hurthle Cell Carcinoma, and could cause the cancer cells to migrate when the needle is removed during the ablation procedure. Following my biopsy to see if I would be a candidate for the ablation procedure, I started having thyroid related issues. (Prior to this procedure, my thyroid was working fine and my only symptoms were related to the large size. )
In my opinion, going to an endocrinologist for a second opinion might make your decision easier. The endocrinologist can run tests that might help make your decision easier.
I was being seen for 10 years for what the doctor thought was a benign nodule that had gotten very large. I did not want to have surgery due to the proximity of the nodule to the laryngeal nerves and concern for voice problems that could affect my ability to work. The doctor thought the nodule was benign, however it was large; and the testing for candidacy for radiofrequency ablation revealed a 50% chance of Hurthle Cell Carcinoma. I had surgery and was diagnosed with Hurthle Cell Carcinoma.
I don’t think you need to worry too much yet. Definitely find an endocrinologist with a background treating cancer and go for a second opinion. I hope this helps!
Good Luck!

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@av8r525

My 38 year old Son went through similar, turned out to be metastatic carcinoma. Has since had thyroid remoted and will begin radiation treatment soon. Wishing you all the best.

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Thanks for sharing! It looks like cancer can happen in young people, also, even though there is only 5% chance that the nodules are cancerous.

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@koh

Hi,
From what I understand, thyroid nodules are fairly common. I don’t know if having multiple nodules is an indicator of a problem or just a regular part of aging. From what I understand, nodules can come and go without people even knowing they were there. However, if the nodules are large or growing they could signal a problem….not necessarily cancer, just a problem because they can start to impact the structures in the area.
In my opinion, you might want to go to an endocrinologist to assess the situation. If the nodules are very small, they would be hard to biopsy and I was told it is usually not done. If the nodules are large it is good to have a biopsy however, biopsies are not always conclusive, so they can do other testing,
In my opinion, the biopsy does not hurt; some were a little uncomfortable, however they really didn’t hurt. The biopsy seems to be used as a predictor for possible cancer and used to help make decisions.
As for cancer spreading from the biopsy….. I was told I did not qualify for Radiofrequency ablation to shrink a large nodule because the cells had a 50% chance of Hurthle Cell Carcinoma, and could cause the cancer cells to migrate when the needle is removed during the ablation procedure. Following my biopsy to see if I would be a candidate for the ablation procedure, I started having thyroid related issues. (Prior to this procedure, my thyroid was working fine and my only symptoms were related to the large size. )
In my opinion, going to an endocrinologist for a second opinion might make your decision easier. The endocrinologist can run tests that might help make your decision easier.
I was being seen for 10 years for what the doctor thought was a benign nodule that had gotten very large. I did not want to have surgery due to the proximity of the nodule to the laryngeal nerves and concern for voice problems that could affect my ability to work. The doctor thought the nodule was benign, however it was large; and the testing for candidacy for radiofrequency ablation revealed a 50% chance of Hurthle Cell Carcinoma. I had surgery and was diagnosed with Hurthle Cell Carcinoma.
I don’t think you need to worry too much yet. Definitely find an endocrinologist with a background treating cancer and go for a second opinion. I hope this helps!
Good Luck!

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Koh,

It sounds like you have been going on this road for a long time….Thanks for sharing your experience! Looks like you have weighed your options and your biopsy experience has confirmed my fears…. One of the largest nodules is 3.9 cm, so large enough to ask for attention. It has gotten to where it was bothering me when swallowing.

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@memada32

Koh,

It sounds like you have been going on this road for a long time….Thanks for sharing your experience! Looks like you have weighed your options and your biopsy experience has confirmed my fears…. One of the largest nodules is 3.9 cm, so large enough to ask for attention. It has gotten to where it was bothering me when swallowing.

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Mermada32-
Yes, my doctor was “ monitoring” my nodule for 10 years and felt it was benign…. Unfortunately, that did not turn out to be right. Biopsies are only as good as the area the cells come from, however they are one of the ways to check for cancerous cells. When I went to another Dr to be evaluated to be a candidate for radio frequency ablation ( a procedure to shrink thyroid nodules so they go away), they also sent slides out for Affirma testing ( from my understanding it tests the genetic make up of the cells from the biopsy). This test revealed a 50 % chance of having Hurthle cell carcinoma. After hearing this and knowing the nodule was very large and causing problems, I had a partial thyroidectomy, which confirmed the cancer diagnosis.
The fine needle biopsy’s are just one tool for helping to diagnose cancer, however there are other tests that can also show an increased possibility so you can make informed decisions… my doctor did not run other tests so I think he just thought he was right…. and I just assumed the doctor knew what was necessary for monitoring.
Don’t get too stressed out about the biopsy because it really just sounds worse than it is. I really think it’s important for you to ask your doctor to refer you to an endocrinologist because they specialize in thyroids.
Try not to worry too much because most nodules are not cancer. If testing shows that it appears benign, you might want to inquire about ways to try and shrink it without surgery…. always worth a try!
Good luck!

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@memada32, it sounds like you are concerned that getting a biopsy might cause cancer to spread. Here are a few articles dispelling that myth.

– Mayo Researchers Find Cancer Biopsies Do Not Promote Cancer Spread https://newsnetwork.mayoclinic.org/discussion/mayo-researchers-find-cancer-biopsies-do-not-promote-cancer-spread/
"A study of more than 2,000 patients by researchers at Mayo Clinic’s campus in Jacksonville, Florida, has dispelled the myth that cancer biopsies cause cancer to spread. In the Jan. 9 online issue of Gut, they show that patients who received a biopsy had a better outcome and longer survival than patients who did not have a biopsy."

NCI Common Cancer Myths and Misconceptions: https://www.cancer.gov/about-cancer/causes-prevention/risk/myths
"The chance that surgery will cause cancer to spread to other parts of the body is extremely low. Following standard procedures, surgeons use special methods and take many steps to prevent cancer cells from spreading during biopsies or surgery to remove tumors. For example, if they must remove tissue from more than one area of the body, they use different surgical tools for each area."

If I have read your original post correctly, you do not have a diagnosis of cancer and that your doctor recommends doing a biopsy to verify or rule out cancer. Is that correct?

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Update: I did go ahead and have the biopsy and it turned out to be inconclusive. The recommendation is to have another one….TBD I guess

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@memada32

Update: I did go ahead and have the biopsy and it turned out to be inconclusive. The recommendation is to have another one….TBD I guess

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I had a biopsy that was inconclusive and they took another sample to be sent out for Affirma testing. From my understanding, it is a genetic type test of the cells. Affirma testing appears to have a very good prediction rate for identifying cancer.
My doctor had been “ monitoring” my nodule for 10 years and never did this test. When I was being screened at another hospital to see if I was a candidate to have radio frequency ablation to shrink the nodule, they ran the test. The Affirma testing revealed that I had a 50% chance of having Hurthle Cell Carcinoma; which was confirmed when I had surgery.
Maybe you can ask if your doctor could run this test so you can make an informed decision.

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Same thing happened to me. I was wondering how is your treatment going after your surgery?

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I have not really had any other “treatments;” just monitoring. I had surgery in July. I have been having bloodwork to monitor thyroid function and recently had ultrasound and CT to check on internal pain and a lump in my throat. I started Synthroid about6 weeks ago.

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