My thyroid ultrasound

[Scarlett]

This is what my doctor says 

<<<Your ultrasound revealed multiple small cysts and one possible solid nodule, but these were all too small to biopsy.  Rather, we should repeat the ultrasound in one year for monitoring.>>>.       Does anyone have any experience with something like this?

[Katy]

No.  Sounds scary.  So glad whatever it is, it was caught early. I might get a second opinion for something like that.

[Dmmetler]

Do you have Hashimoto's? That would be fairly common with Hashi's, but apparently they look different to someone who knows what they're looking for, so it's possible to decide they're not a big risk without biopsy. 

[Brittany1116]

Yes, they just scanned it for a few years and in conjunction with my labs decided it wasn't changing and not something that had to be monitored as frequently. 

[Scarlett]

13 minutes ago, Dmmetler said:

Do you have Hashimoto's? That would be fairly common with Hashi's, but apparently they look different to someone who knows what they're looking for, so it's possible to decide they're not a big risk without biopsy. 

I do not. My thyroid blood work is fine.  In fact all my labs are almost perfect. 

[kbutton]

There are scoring rubrics online for thyroid nodules and what is concerning vs. not. There might be information in the report about what made them decide to monitor. I would not worry if they are content to monitor them.

[Scarlett]

My largest cyst is 1.6 X 1.4 x 1 cm. 

[alisoncooks]

My oldest dd has had multiple nodules. One side of her thyroid had large nodules (the lump was visible on her neck), and they ended up surgically removing half of her thyroid. We chose to leave half (hoping to avoid dependence on meds at such a young age), despite that remaining side also having nodules (smaller ones). We go back for ultrasounds each year. She’s also had several ultrasound-guided biopsies. 

[Scarlett]

36 minutes ago, alisoncooks said:

My oldest dd has had multiple nodules. One side of her thyroid had large nodules (the lump was visible on her neck), and they ended up surgically removing half of her thyroid. We chose to leave half (hoping to avoid dependence on meds at such a young age), despite that remaining side also having nodules (smaller ones). We go back for ultrasounds each year. She’s also had several ultrasound-guided biopsies. 

Is she still ok without meds?

[dirty ethel rackham]

54 minutes ago, Scarlett said:

My largest cyst is 1.6 X 1.4 x 1 cm. 

Lots of people have nodules and don't know it.  I rarely scanned a thyroid that didn't have any nodules.  The size usually isn't an issue unless it is so big that it is pressing on other structures and causing difficulties like @alisoncooks's daughter.  The characteristics of the nodule are more important. A cyst of that size is likely large enough to be biopsied unless it is located too close to blood vessels or otherwise difficult to access, but if it looks unremarkable, then they wouldn't have concerns.  The solid nodule may again be not that concerning if it doesn't have unusual blood flow or calcifications.  It is super common to just follow thyroid nodules to see if they remain stable.   I have nodules that were discovered nearly 20 years ago .  

[alisoncooks]

10 hours ago, Scarlett said:

Is she still ok without meds?

Yes, so far her remaining thyroid is functioning fine. They were also careful to leave the parathyroid, which isn’t always possible but is vital for calcium absorption (so again, avoided meds).  They monitor her levels at her check ups.

I had a cyst near my thyroid when I was in college. It was big enough that they drained it, and it’s never come back and it wasn’t problematic. 

Re: whether nodules are cause to be concerned (ie cancer). We were told that if DD’s nodules were cancerous (they’re weren’t; most aren’t), thyroid cancer tends to be *very* slow growing with excellent prognosis. (Just throwing that out there in case your mind had gone there already.)

[MercyA]

Yes, I had an enlarged thyroid back in 2008 and cysts and (IIRC) at least one nodule were found. They did an ultrasound-guided biopsy and everything was fine. That was it. My impression was that these things are really super common and they were being overly cautious.

I would not worry if I were you, honestly.

I do have hypothyroidism and take Synthroid, but that is because of my bloodwork. 

[Laurel-in-CA]

I found nodules or cysts on my thyroid in my 20s, big enough that I could feel them in my neck. Dr. gave me the option of needle biopsy or surgery and I chose surgery...and they turned out to be malignant so I had to do the whole radioactive thyroid treatment and medication for life. But I still had 4 children and have done quite well. Thyroid cancer (not that this would be what you have going on) is VERY slow growing and my dr. said even people who have it usually die of something else. Be sure.

[J-rap]

I had a nodule over 25 years ago.  The surgeon did a needle biopsy and determined it was cancerous, so I had surgery to remove it entirely.  (I went to another hospital to have it removed.)  During the surgery, it was biopsied and discovered that it was pre-cancerous cells, not actual cancerous cells, but they made the decision to remove it anyway so I'd never have to worry about it.  Because it wasn't actually cancerous, I never needed the radioactive treatment.  I've been on synthroid ever since and have never had any problems at all.  

However, the doctor was never too concerned, because apparently thyroid cancer is generally slow growing.

[popmom]

13 hours ago, MercyA said:

Yes, I had an enlarged thyroid back in 2008 and cysts and (IIRC) at least one nodule were found. They did an ultrasound-guided biopsy and everything was fine. That was it. My impression was that these things are really super common and they were being overly cautious.

I would not worry if I were you, honestly.

I do have hypothyroidism and take Synthroid, but that is because of my bloodwork. 

I know of at least 2 women with similar experiences. It is pretty common. I mean, it's totally understandable to be concerned. I always advise getting second opinions. @Scarlett what type of doctor ordered the scans? A surgeon?

ETA: my mother had radioactive iodine about 25 years ago, and she has never had to take meds. She didn't have cancer though--I guess it was enlarged. 

Edited January 8, 2023 by popmom

[Scarlett]

25 minutes ago, popmom said:

I know of at least 2 women with similar experiences. It is pretty common. I mean, it's totally understandable to be concerned. I always advise getting second opinions. @Scarlett what type of doctor ordered the scans? A surgeon?

ETA: my mother had radioactive iodine about 25 years ago, and she has never had to take meds. She didn't have cancer though--I guess it was enlarged. 

My GP.  He felt of it during my regular check up and said it was enlarged. 

[popmom]

6 minutes ago, Scarlett said:

My GP.  He felt of it during my regular check up and said it was enlarged. 

But he didn't "read" the ultrasound. So a radiologist would have made that recommendation--is that correct? I'm asking because I've been through this multiple times with breast tumors. It would be perfectly appropriate for you to ask around for a recommendation for a surgeon who does a lot of thyroids (BUT ISN'T KNIFE HAPPY--they do exist) for a second opinion. Surgeons sometimes have different perspectives than radiologists and in my experience--are usually MORE conservative than the radiologists. YMMV of course. 🙂

ETA: I misspoke! In my experience the surgeon is often more conservative than the pathologist after biopsy. But still--having a surgeon take a look at the radiology report couldn't hurt if you are concerned. The surgeon would be the one to do the biopsy. Or at least that would be my preference. I have had radiologists do breast biopsies, but once I was established with surgeon--I definitely would prefer the surgeon do it.

Edited January 8, 2023 by popmom

[Scarlett]

2 minutes ago, popmom said:

But he didn't "read" the ultrasound. So a radiologist would have made that recommendation--is that correct? I'm asking because I've been through this multiple times with breast tumors. It would be perfectly appropriate for you to ask around for a recommendation for a surgeon who does a lot of thyroids (BUT ISN'T KNIFE HAPPY--they do exist) for a second opinion. Surgeons sometimes have different perspectives than radiologists and in my experience--are usually MORE conservative than the radiologists. YMMV of course. 🙂

Yes correct.  Radiologist read it and said it did not meet the standard for biopsy. The Gp then said we would check it again in a year.   

[popmom]

Just now, Scarlett said:

Yes correct.  Radiologist read it and said it did not meet the standard for biopsy. The Gp then said we would check it again in a year.   

Got it. I just edited my post, so you can look at my clarification. 🙂 Personally, I wouldn't worry.

[dirty ethel rackham]

On 1/7/2023 at 10:53 PM, popmom said:

The surgeon would be the one to do the biopsy. Or at least that would be my preference. I have had radiologists do breast biopsies, but once I was established with surgeon--I definitely would prefer the surgeon do it.

Everywhere I've worked (or done clinicals), the radiologist did the biopsies.  I don't know if all rads do them, but we had certain ones that did biopsies.   I've assisted with dozens of fine needle aspiration biopsies and never saw a surgeon.  At one hospital, the pathologist would be in the room for thyroid biopsies to look at the sample to make sure that the it contained enough cells.  

[alisoncooks]

1 hour ago, dirty ethel rackham said:

Everywhere I've worked (or done clinicals), the radiologist did the biopsies.  I don't know if all rads do them, but we had certain ones that did biopsies.   I've assisted with dozens of fine needle aspiration biopsies and never saw a surgeon.  At one hospital, the pathologist would be in the room for thyroid biopsies to look at the sample to make sure that the it contained enough cells.  

All of my daughter’s biopsies were done by the radiologist. Then they’d pass it through a little window to the pathologist. Then all those results would go to our ENT/surgeon, who’d discuss with us.