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My doctor told me I have a thyroid nodule.  What are the chances that I have thyroid cancer?

Dr. Christine Landry  

Christine Landry, MD, is a surgical oncologist at at Banner MD Anderson Cancer Center.

Question: My doctor told me I have a thyroid nodule.  What are the chances that I have thyroid cancer?

Answer:  Palpable thyroid nodules are present in as many as 4-7 percent of the population, while ultrasound can detect thyroid nodules in as much as 67 percent of the general population. Thyroid nodules are more common in women, and only 5-12 percent of these masses actually contain cancer cells. The American Cancer Society estimates that in 2011 approximately 48,020 individuals will be diagnosed with thyroid cancer, and 1,740 patients will die of thyroid cancer.

Evaluation of a thyroid nodule usually begins with a physical exam, thyroid function tests, and ultrasound of the neck. If the nodule has abnormal findings on the ultrasound, a biopsy will be performed to further analyze the nodule. If cancer cells or other abnormal cells are identified, your doctor may recommend an operation to remove the thyroid gland. If the results of the biopsy are benign, the nodule may need to be followed with ultrasound to make sure the nodule does not change.

Types of thyroid cancer

  1. Papillary thyroid cancer:  Papillary thyroid cancer comprises as much as 80 percent of all thyroid cancers and is associated with an excellent prognosis. This cancer tends to grow very slowly, and may spread to other lymph nodes in the neck. The five-year survival approaches 100 percent for stages I and II.
  2. Follicular thyroid cancer:  Follicular thyroid cancer comprises approximately 15 percent of all thyroid cancers, and also carries an excellent prognosis. Like papillary thyroid cancer, the 5-year survival for follicular thyroid cancer approaches 100 percent for stages I and II.
  3. Medullary thyroid cancer: Medullary thyroid cancer comprises approximately 3 percent of all thyroid cancers and is commonly associated with hereditary conditions such as multiple endocrine neoplasia type 2 (MEN2). The prognosis is good if treated early, but worse if diagnosed late in the course of disease.
  4. Anaplastic thyroid cancer: Anaplastic thyroid cancer comprises only 2 percent of thyroid cancers, but is associated with the worst prognosis. Most patients are not candidates for surgery. The five-year survival is approximately 7 percent.

 

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