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Suspicious thyroid biopsy (Page 1)

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I had thyroid biopsy done recently and it came back "suspicious".
Doctor told me that the thyroid cells are neither clearly benign nor malignant, and
25% of suspicious lesions are found to be malignant when people with this undergo thyroid surgery and the removed thyroid is further examined.
So, the doctor told me I need to choose to have surgery done or keep monitoring.

I am 30f with no family history of any cancer.
All my blood work including TSH, T3, and T4 are normal.
I have no symptoms of either hyper or hypo thyroid.
There are 2 nodules and both are about 4cm. (this makes my doctor concern a lot)

I've always believed in natural medicine and hated relying on medication.
(when I get headache, instead of taking painkiller, I do yoga or take natural herbs. )
So surgery is my last option, but I also don't want to keep worrying and monitoring every 6 months.

Has anyone had biopsy result of "suspicious"?
What did you do??
Thank you for taking your time to read this.
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First Helper User Profile MyrahU
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replied November 6th, 2008
I'm in the same position you are. 4.7cm nodule, came back as "supicious for follicular neoplasm" on the 3rd FNA. No family history of thyroid problems.

I've been doing a wait and watch for the past year, largely because I felt that surgery should be a last option, not a first choice. Also figured the odds were in my favor of it being benign.

I've been using alternative methods to try to shrink the nodule (herbs, supplements, iodine). I've had some small success (nodule shrank down to 3.5cm), but don't know if that's due to the alternative methods or to the serial biopsies (3 in 11 months).

Unfortunately, I seem to have reached a standstill so I'm currently shopping around for a surgeon I feel comfortable with. I hate the idea of getting surgery but, due to other health issues, have had to decide which battles are more important to me. At least, once the nodule is out, that particular battle will be over and I can dedicate more energy to other issues.

Good luck and good health to you no matter which way you choose to deal with this.
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replied January 25th, 2009
Suspicious thyroid biopsy
reply to nyxie63 ;
I'm also in the same boat! Had FNA done in 2005 I've not dealt with it nor had the nodules removed. I'm at a standstill myself -- not sure what to do; I went to the Dr in 2005 - 1st visit he said; yup nodules; 2nd visit he suggested FNA- 3rd visit- suspicioius ; 4th visit -- wanted to do surgery; I decided not to do the surgery; cuase I wanted more informatino and a second opinon; well I've had 3 opinions and none of these other Thyroid Dr.s have scheduled FNA's rather than just Scans and none feel I need Med's or surgery - even tho they also have the same paper work from the 1st dr. I'm really confused! If any one can shed some light that would be most helpful! I'm almost 50! eeks
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replied April 21st, 2009
Daniel
My FNA came back as suspicious for neoplasm on my right thyroid lobe. the module measures .9cm. Surgery is my last option, however at this point a person can save the full thyroid by having half removed. I was told that even though there is a 25% chance of being a neoplasm, I can save the full thyroid. I am really considering surgery. Let us be safe, and live without dependence on hormone therapy. You guys will all be alright, and well. I wish you all the best, including myself.
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replied April 21st, 2009
Extremely eHealthy
Been there, too.
I had the same dilemma three years ago (I was 24) when the nodule on my right thyroid lobe kept growing (although slowly over the course of two years before that) and the FNA was inconclusive, but showed something called Hurthle cells (which made it more likely to be cancerous).

I had my right lobe removed and after they examined it, they saw that it was cancerous and removed my other lobe a month later.

I was really lucky to have a great ENT who answered all my questions (and I had a lot of them!) who was also a great surgeon (people can't really see the scar now unless I point it out).

It's been three years. After the surgery, I had radioactive iodine treatment and have been cancer-free ever since.

I know the thought of being dependent on thyroid medication for the rest of your life is really difficult, but if your surgeon believes you should have the surgery, do your research, ask other experts, but don't dismiss the idea. Although Thyroid Cancer is usually slow-growing, it can spread. Most types are so easily cured.

All I can really tell you to do is not to make any decision out of fear. Don't let it go because you are worried about the surgery. If you do your research, get second opinions, and still decide to wait, that's your right. Just keep getting it checked and don't wait until it's too late. Please.
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replied May 2nd, 2009
I'm a 32 y/o male that had a "suspicious" FNA on a 2.5 cm thyroid nodule. I did not want surgery at all...felt I was just too healthy for surgery. However, the thought of not dealing with a nodule that had a 33% (1 in 3 chances) of being cancer convinced by to get the surgery. At this point I thought it would be best to get it out.

So I had a thyroid lobectomy (took out half the thyroid). The pathology report came back as papillary cancer so two days later I had a second surgery to remove the entire thyroid. Then a few weeks later I had the radioactive iodine treatment.

I know surgery is scary but you should really listen to your endocrinologist. Nobody wants surgery…I sure didn’t want it but if having surgery means curing cancer it’s worth it. The fact that I got the cancer remove early will hopefully aid in my prognosis.

It has been four months since my surgery and I'm feeling well. I'm still working on adjusting my thyroid medication.

O yeah, I had the minimally invasive thyroidectomy surgery. This is a new surgery that only leaves a one inch scar…very nice!

Kenny
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replied May 22nd, 2009
Wanna know position of 2nd surgery
Hi Kenny,
I want to know position of second surgery.
Is it the same position as the first one?
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replied August 5th, 2009
Hi all I just wrote my whole dilemma and it never came thru errr.. Anyway here we go again. LOL Im in the same boat.. I will try to condense it this time.. I have Graves(hyperthyroism) I was diagnoised with it April 08 put on meds.. I also had an uptake and a biopsy all was normal I did have a nodule 1.7cm.. Let me back track a little in 2005 i was diagnoised with hashimoto was put on armour my levels went way out of control after 6 months i was told to go off i did after a month or so I felt wonderful stupid me never going back to the endo(we lived in Florida at the time) Ok present.. i was on my meds for the graves till April 09(1 full yr on them) my levels had been perfect since late winter so i was stable i didnt need the meds anymore.. Yes all was fine i felt great i was going monthly my levels perfect.. July 20 i went and had blood drawn again perfect had my exam also perfect.. My endo said ok well lets go for another ultrasound. i go and the tech was so quick i thought to myself hmmm maybe an issue anyway my we get back the report it shows the nodule grew from 1.7 to 2.4 since april 08 but I was not confident with the tech so my endo had me go to a hospital and get it done now 2 days later its 3.5 . Scared the you know what out of me 1+ full cm in 2 days..(We are hoping the 1st tech did screw up) anyway off for the biopsy got the report back the findings say the cells they found were inline with my Graves(meaning what they expected to see with someone with Graves...Follicular cells in Trabecular Pattern) but the comment below says but.... cant completely rule out papillary carcinoma..(due to the small sample that was taken...the sample was 1.6 cm and it was done by a core biopsy)It floors me when they are checking for cancer they only take 1 sample they should be taking as many as they can..... errr then it says close followup is reccommended... My endo says get it out go for surgery... i am going to go get a 2nd opionion and most likely another dreaded biopsy..
Here's a strange thing that happened.. 2 days before the 1st ultrasound i had a mole on my leg that needed to be removed(thank g-d thats ok) they swapped it with iododine.. all of a sudden slowly my graves symptons started coming back..but by the time the biopsy was done they were back 100% so strange it happening so quick in such a short time where i hadnt had 1 sympton since i would say Feb 09..(now all with in 1 week) Anyway i would like to know if anyone has had a similar experience and what the out come was. We live in Houston now anyone have any reccommendations for a good surgeon somewhere in Texas..(perferably miniamlly invasive or robotic) just in case I opt for the surgery if it cannot be posted can you send me a private message Thanks Smile Hoping for everyones positive outcome!!!
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replied August 5th, 2009
Extremely eHealthy
First of all, I can understand your point about the biopsy, but really, a 3.5 centimeter target isn't as big as it sounds. It's big in your neck, but not when you are aiming a needle at it. One sample is normal, especially when they see the fluid that comes out looks like they got a good sample (ie. not blood or fluid that's too clear).

A second opinion is a good idea, since you're getting some vague and conflicting test results. I would find a good ENT (not an endo) and take your records there. Personally, I did a similar back-and-fourth thing getting ultrasounds and biopsies. The ultrasounds showed growth over the course of three tests and the biopsies were inconclusive. Unfortunately, the biopsies are not terribly accurate. There are significant rates of false-positives, false-negatives, and "inconclusive" results. Many people (including myself) never get a clear diagnosis of cancer before they go in for surgery. It's more of an odds thing that you and your doctor need to discuss. Mine was growing and there were "suspicious" cells, so I had the surgery and it was cancer. Some people play those same odds and find out that it's not cancer, so they keep the second half of their thyroid and chalk it up to being cautious.

Also note that thyroid cancer rarely presents with any symptoms other than the growth. All my thyroid tests came out completely normal and I felt fine.

If you were on the central coast of California, I could recommend a great ENT surgeon, but I don't know anyone in Texas, sorry. I've heard it can be done with a very small incision, but it depends on where yours is and how hard it is to get at the nodule. After having the same 3inch incision open in my neck twice, you can barely see it now. It's on the neck crease, so it blends in. In other words, if it has to be done, you shouldn't have much scaring as long as you keep it out of the sun and keep it moisturized.

If you need more information, there are a lot of us on here who have been through this stuff, so feel free to post again. Good luck with everything. Let us know how things turn out.
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replied August 5th, 2009
Thanks for taking the time to get back to me.. Smile I did get my blood tests back.. but it is still in normal range but a big drop in my tsh i was at approx 1.250 now its right at .90 so my hyper symptons were not in my mind LOL... Why do you feel an ent is a better choice then a endo? I have sent all my paperwork to a endo at md anderson..(top notch cancer hospital here in Houston) I have read up on her and I like what i have read... I also have an ent I like very much here i can go see her as well... There is nothing on my reports as far as "suspicious" the only mention is his remark about possibly not ruling out papillary carcinoma.. I want to make sure I have all my eggs in the basket before I opt for surgery. i will for certain let you know.. I like everyone else in here are so grateful for these boards.. it sure helps to talk about it.. I havent really slept since the 1st ultrasound... hopefully soon I could have a good night sleep!!
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replied August 6th, 2009
Extremely eHealthy
From what I've read, most endocrinologists aren't surgeons, so they have to send their cancer patients to ENTs, anyway. If you find an endo that is an experienced surgeon, go for it. Where I lived when I was going through this, there wasn't a endo within 40 miles, so I found a good ENT.

The surgery decision will ultimately be up to you. Although I know it's scary and nerve-wracking, it's not so bad. I would recommend doing some research on your own into the topic. Personally, I was completely freaked out when they told me about my nodule and that it may be cancer. But after I did some research, I found how many of these nodules are actually benign and how easy the treatment would be if it was cancer (a breeze compared to other cancers). Plus, the cure rate is ridiculously high.

Don't let this run your life, especially right now. It may be a while before you really know anything. Often, doctors take the "wait and see" approach with these things because they are so slow growing. Go read some websites and buy some books. The more you know, the more you'll feel like you can fully participate in the decision-making with your doctor.

Let us know if you need more information. Now go get some sleep! Smile
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replied August 11th, 2009
Thanks. Smile I did find a endo surgeon from Md anderson. Not sure if you ever heard of this cancer hospital but it is I beleive # 1 in the country maybe the world..(and its right in my back yard about 45 mins away) I did research and came up with this surgeon.. I liked what I read and heard through her case studies.. but obviosuly so does everyone else cause the earliest appt I could get was Sept 23 for testing and the 24th to see her.. So I am more relaxed but not fully so now its the wait (6 weeks) to see her... but I know I am in good hands at this instituiton. I have been reading alot thats good and bad cause my "symptons" could be cancer may not...
The strange thing that has been happening is my ears are clogged all the time...backtrack a little prior to the 1st ultrasound.. I had a post nasal drip(I have allergies) and wondering if with all this aggravated it all.. Another thing its been about 2 weeks since the biopsy and when i press on the nodule it still hurts.. (and no it did not hurt prior to the biopsy) is that common? When the biopsy was done my neck immediately swelled up.. I had to have an ice pack on it for hours and it took days for even slight swelling to go down(I had a core biopsy).. Anway what do you think? Thanks Smile
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replied August 12th, 2009
Extremely eHealthy
I don't think this would affect your allergies at all. After the biopsy, your neck can be sore for a while. If it continues to be, I would call the doctor who did it to make sure that it's normal for it to be sore for that long.

I'm glad you found a doctor you feel confidence in. That's so important with things like this. Just make sure that you get all your questions answered and don't get rushed out of there (she sounds pretty busy). Make sure you understand what plan is (further tests? "wait and see"? etc.) and what your options are at this point. The plan is very important because you will know what is going to happen and maybe you can relax a bit because you'll know that things are being taken care of.

In the mean time, put it out of your mind as much as you can. If it makes you feel better, do some more research, but don't let this run your life. When you have a question or a concern, write it down on the list you'll take to the doctor and let it stay there. Tell yourself that it's on the list and you can't do anything by worrying. The six weeks will go by faster if you don't let yourself agonize over this.

Good luck. Keep us posted. If you have any questions, please feel free to write back.
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replied August 13th, 2009
Thanks for getting back. Well they had a cancelation and Im going for my testing tommorrow.. and seeing the Dr on the the 27th of this month so the wait will be over for now. I still have allergy symptons and my neck is still sore so im a bit paniced over that.. the nodule is sore when its pressed in.. my pain tolerance is high but not sure how high.. I will let you know how it goes thanks again.. Smile
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replied August 14th, 2009
Update... I had my appt today .. I get a very lengthly ultrasound where they checked throughout the thyroid and the lympth glands.. she comes back and said.. "the slides from your 7/29 bioposy hasnt come to us yet and the radiologist said you dont need the biopsy" . They had also called my new endo at the facilty(who I have not seen yet not till the 27th) and she also felt it isnt needed.. OK then what is that saying. that from the written report and the new US they did today suggest I am in the clear and not need it.. How can he tell from the US.. the tech did say when they finally get it(I checked and the slides showed up yesterday but obviously the pathologist never looked at them.err)and if he sees something on the slide that he doesnt like then I will have to go back for the biopsy.. I wanted this over today.. But as my husband said if he saw something that didnt look right on the US there would have been no question I would have had the biopsy... but really who knows.. so now i need to wait thru the weekend to hear something! Another question if anyone can answer i noticed my snicker proteins bar main ingredient is soy I heard soy is a no no but I only eat maybe one bar a day is there a safe amount of soy a person with a thyroid issue can consume TIA
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replied September 3rd, 2009
I had my surgery yesterday and it went for the most part smooth(Couldnt get the iv in cause I was so dehydrated it took a few tries) anyway my Dr checked around took out 1/2 the thyroid and said all looked ok but obviously have to wait till the biopsy of that 1/2 comes back.. if that comes out ok Im done no meds as long as my blood levels are good.. if the biopsy doesnt come back good then in for another surgery and get the other 1/2 out and then radiation and put on meds so now its a wait and see game now... I have a stiff neck sore throat and bouts of larengitis(I have to keep clearing my voice) but I have not had to take anything stronger then an extra strength tylenol.. I may though tonight take the prescribed one so I sleep well. Everyone be well
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replied September 4th, 2009
Extremely eHealthy
Glad you're doing well. Once the stitches come out, make sure to keep the area moisturized and protected from the sun with sunscreen so the scar goes away faster. Smile
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replied February 15th, 2010
I went to work this morning, knowing I had to leave early to take my daughter to the ENT today for preop for tonsillectomy,andenoidectomy, and turbinate (sp?) reduction. My office refers to this particular ENT all the time since he is top notch. I have not heard anything negative about him. So, I phoned over to see if they could get me in to get established at the same time we had to pick up my daughter's paperwork to take to the surgery center. To my surprise they could! I knew I needed to get a second opinion about the follicular adenoma/neoplasm since it has been three months since going to Moffitt Cancer Center Endocrine Tumor Program. I brought all of my test results and he looked everything over. He asked how it all started last April... I said with pain (dull constant ache). He agreed with endogrinologist that the lobe should be removed. He spent quite a bit of time listening to me and noted the growth in the nodule when he palpated. He validated my pain by saying that it was a way to let me know my body was responding to something that should not be there. He has all records except my slides and films, which are at Moffitt, but I do not think he needs them since he has the reports. I simply asked him what would he suggest I do and he said it definately needed to come out and I agreed to let him be my surgeon. I asked him how he planned to do the surgery and he told me he does the traditional cut. He explained that way may be best so he could place a drain to control a possible hematoma since I have developed them after every surgery so far. He walked me to the surgery scheduler's office and chatted with her while I waited and she asked me to come in and told me he wanted the first available date. I did not expect to be scheduled so quickly, I guess, since I just went in for a second opinion and to discuss my case. At first I kinda freaked that there was an opening on the 26th (my anniversary) so I asked her if we might be able to PENCIL it in for the following month, because I needed to talk to my family and my job, and she did. We decided on March 2nd and that was the latest she wanted me to go out. I was able to sit and discuss all the details with my husband. He had a lot of questions of course and he said to go ahead with Feb. 26th. He dosen't want to wait. I called the Scheduler with him and she said that would be fine but she would be at my chosen hospital on the 16th (Feb.) with Dr. for surgeries that morning. They perform surgery at two hospitals in the area and he also works at a free standing surgery center where he is part owner. She told me he may be able to cancel his office visits, or clinic to be able to do it that afternoon. I was shocked that he would do that! I told her that I would wait until the 26th and she said the 16th would be fine and to give her 10 minutes so she could text him! Wow, I felt odd, lol. She called me back in five and told me he said it was a go and to be back there on Monday for preop at 1pm AND told me she was going to book me to see him, which is not heard of! He is cancelling his clinic for that afternoon! She said to gather all the questions and bring them in and he will patiently answer all of them. So! Surgery is set for Feb 16th 2010. I am comfortable with this as I am very tired of dealing with the achiness in my throas and the other symptoms. I am not ready for the healing time and the wait for pathology to come back, even though I KNOW God is performing miracles and all WILL come back fine! I have had to deal with surgical menopause and hate the idea of another hormone shift. However this has been going on since last April-May and this too shall pass, right?
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replied February 16th, 2010
Extremely eHealthy
Wow. It sounds like you got a great doctor with a great office staff that is willing to go the extra mile.

You may not even have to deal with a hormone shift if your other lobe can make enough hormone. Even if it can't, you still won't need to be on as much as if you had the entire thyroid removed. Just make sure that if you do go on thyroid hormones that you take them as directed (same time every day on an empty stomach, etc.)

Let us know if you have any questions about anything. Just make sure to call your doctor first if it's something important or specific to your case. The main thing you can do now is relax and recover once the surgery is over.

Oh and once you get the stitches out, make sure to keep the scar out of the sun (use sunscreen on it) and keep it moisturized. That should make it heal much nicer.

Good luck with everything!
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replied March 5th, 2010
Im 41 and was also told 4 days ago i have Follicular carcinoma.
They said it was only 1cm and looked suspicious. Im now am waiting to see the surgeon in a week to talk about what to do. Only i dont just have one nodule, I have 4 of them, all under 1cm. Im scared to death here and dont know who to talk to for comfort or how to stop thinking about this. It has consumed my mind.
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