multiple nodules in neck/thyroid need biopsy any btdt?

[hillview]

I've had this lump in my throat for about a year and my doc initially said it was no big deal. I recently went back to my doc and he ordered an ultrasound which I got yesterday. Today I got the results which was multiple nodules in my thyroid and that i need multiple biopsies. He also said that they were "not particularly suspicious" I have to wait to get a biopsy scheduled. My TSH results have been fine. Anyone btdt and have advice? Thanks. I am trying not to freak out.

[AnnieW625]

I gave no btdt, but my mom had a growth on her pituitary gland for years and she had no idea. She had under-active thyroid from her teens until her early 30s and then it somehow went away, and then she was diagnosed with Cushings Syndrome at 64 due to the tumor, and she had the bulk of the symptoms for many years (headaches, unexplained weight gain, thinning skin, menopause went on for 8 years andcsuper irregular periods prior) and had no clue. In the months prior to the diagnosis we seriously thought she had early onset Alzheimer’s disease because she had become crazy unreasonable, would forget to take her meds (she had back surgery in March and was fine for six months prior to the symptoms all showing up at once, and was going to pain management) and would forget by 2 pm what her doctor at 10 am had told her. She also fell at least twice at home and wouldn’t let my dad call 911 because she was fine, but she had no muscle tone, and therefore couldn’t walk.


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[magnoliaparadise]

I have a module that is checked every few years (to make sure it hasn't grown) and I have been given synthroid off and on (to see if it grows despite synthroid, which apparently wouldn't be good). This has been going on for years (like at least 20). I went to a regular check up when I was younger and an internist happened to feel it.

At the beginning, for reasons I don't understand now, the doctors wanted to biopsy every time - maybe every 6 months or year, I can't remember. I think I got the biopsy three or four times. Then I moved at one point and the new doctor thought it was odd that the old doctors biopsied. The new doctor kind of said, in a very very subtle way, that some doctors are slap happy to do procedures for the experience and insurance, but that in my case, she didn't think that they should have given that it hadn't been growing. The new doctor said an ultrasound every two years was enough. So that's what they did/do with the assumption that if there hadn't been growth, no biopsy would be necessary.
This is helpful because I'm realizing that I'm due for an ultrasound, so thank you.

The first few times, the biopsy was... uncomfortable (because it was on my neck and there were hands and a person near my face, I kept having the fight or flight instinct to attack the doctor and his needle), but bearable. And I was very grateful that I was having it done. I learned later that the doctor who would do the biopsy was a total beginner - like this was a very very new procedure for him to do. I learned that because the fourth time I had the biopsy (or whatever the last time was), the (more experienced) doctor was so much better. I noticed a huge difference. And then he somehow relayed to me that my prior biopsies had been done by a new guy (there was some context in which this came up - he wasn't gossiping).

Make sure that the doctor who does it has experience and doesn't send in a new doctor/assistant. Also, if you think you might have needle fears, or are worried about anything/pain, ask if you can have aspirin ahead of time. I have no idea if you can. I have never done that, but probably would ask if it were possible if I had to do it in the future.

Great that you are getting this done and checking it out.

[AngB]

I'm a sonographer and during our first time practicing scanning our thyroids during ultrasound school a couple years ago found my yucky 2.5 cm thyroid nodule. It has/had all the "bad" characteristics- size (our doctors typically don't recommend biopsy for nodules under a cm to 1.5 cm), very vascular (lots of blood flow), and being a solitary nodule is actually statistically more likely malignant than having multiple nodules.

I was in the middle of ultrasound school which was an intense full-time program with no time off so after initially panicking and texting my mom that I had thyroid cancer (oops, poor mom)' and then spending probably 48 hours researching; I decided I did not want to open that can of worms yet and just watched it for a year until I had time to deal with getting it removed if it was malignant. (It actually got a little bit smaller over the year.) I actually had my biopsy this January before deciding to get pregnant again and thankfully it was benign. The biopsy wasn't fun but wasn't really too bad. Just a needle in your neck, but the needle is pretty small, and typically they use lidocaine and numb you first.

Thyroid nodules are extremely common, pretty much like moles. It's very rare that we scan someone who has a perfect thyroid. I think I have probably scanned at least 500 thyroids with at least one nodule or more, and maybe 10 that were perfect, ultrasound school included. Our rads don't typically recommend biopsy unless they are at least a cm. They are also less likely to recommend it if there are more than one. That said, they do recommend biopsies pretty often---to be a cynic, it does rake in a lot of money (mine cost $1200 OOP and I was an employee of the hospital!)--and medicine is all about covering their butts these days. If I remember correctly, 97% of thyroid nodules end up being benign. AND, worst case scenario, if it does end up malignant, thyroid cancer is almost always confined to the thyroid, it is treated relatively easily with just a thyroidectomy in most cases, and it is not typically an aggressive or fast growing cancer at all. (One of our rads always tells patients, "if you have to have a cancer, this is the best one to have.")

For your biopsy, I personally would not go anywhere that did it without ultrasound guidance. (Believe it or not, there are some doctors that will try to biopsy without imaging guidance.) AND, in my area it varies widely by hospital, but the lidocaine they use to numb your neck can contaminate the biopsied cell samples. Most of the hospitals in our area avoid this by having lab techs sitting in the room with the biopsy and their microscope and cell slide kit things, the doctor brings them each sample immediately after each "pass", and they make sure the cell sample is not contaminated immediately...the last thing you want to go through is having needles in your neck only to find out that it was "inconclusive" which typically is because they did not get good samples. I would call and find out how it's done first when you schedule it. You can always request your images and your report and go to a different facility, you are absolutely not "stuck" with wherever you had your ultrasound done.

Good luck, keeping my fingers crossed for good news!

[niccig]

Yep BTDT. Benign nodule that was eventually removed and I had a partial thyroidectomy. Take some Advil before the biopsy - it’s not too painful. I do a breathing meditation during procedures like this. If they do recommend surgery, do it sooner than later. I let mine go and it got bigger and I ended up with complications because of the large size.

See an endocrinologist that specializes in thyroid conditions. I didn’t at first and when I finally did, dr was surprised I hadn’t had surgery earlier.

Post back with details. Most likely it is benign.


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