Thyroid nodules: what are they?

Many of the lumps that appear in the front or "anterior" aspect of the neck originate in the thyroid. Finding a lump in your neck is a frightening event and your immediate thoughts may be of cancer. However, the vast majority of thyroid lumps are in fact "benign" - or not cancerous.

How common are thyroid nodules?

A "nodule" is an enlarged area or "lump" of tissue. Thyroid nodules are surprisingly common. How common depends on how hard one looks for them, and your age. Trained physicians may find nodules in 4% Figure 1 - Frequency of thyroid nodules relative to the age of the patient. of women age 40 years and up, simply by feeling for lumps with their hands. If an ultrasound machine is used to examine those same women, as many as 40% of them may have small thyroid nodules. Fortunately, the vast majority of these small nodules are not of any clinical importance. However, exceptions to this rule would include people who have been exposed to radiation as children or people with family histories of thyroid cancer.

What should I do when I find a lump in my neck?

First and foremost do not panic - usually the lumps are not cancerous. However, do not ignore the lump or delay in seeing your doctor. If the lump is in the thyroid, your doctor will usually recommend a fine needle aspiration biopsy (FNAB) and a thyroid stimulating hormone level (TSH) test as the initial investigations. A referral to an endocrinologist or another specialist experienced in thyroid disease may also be necessary. If the FNAB yields a benign result, and the TSH is normal, further investigations are probably not necessary.

The decision to remove a benign nodule is entirely personal. If you think the lump is large enough to be of cosmetic concern, in some cases that may be reason enough to proceed with its surgical removal.

Dr. Richard Bebb, MD 
in association with the MediResource Clinical Team 

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