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undergoing radiation treatment breast cancer, now thyroid

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I am a 64 yo woman now undergoing radiation treatment for breast cancer. My physician ordered an ultrasound of my thyroid gland because I have a family history. My sister had a total thyroidectomy due to four large nodules in her thyroid and a diagnosis of Hashimoto's Thyroiditis. One of her nodules had a very small cancer (1.5 mm). According to her doctors, she does not need further treatment other than supplementation of the thyroid hormone. My thyroid has one solid lump (1 inch) with irregular margins and a smaller lump on the other side. My doctor has recommended a needle biopsy. I am trying to understand what might be the sequence of events. I have 20 more radiation treatments to go. Can I get treatment for the thyroid problem and continue with the radiation? Because my sister had a small cancer in one node, does it mean I will have cancer? I am very afraid. Is the thyroid problem connected to the breast cancer?

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replied February 10th, 2013
Thyroid Cancer Answer A42067
Welcome to e health forum.

Due to lack of complete medical history, access to laboratory and radiological investigation results and lack of physical examination any advice or information provided here is only for educational purposes and cannot replace your treating physician or surgeons advice.

Breast cancer is not directly associated with an increased risk of thyroid cancer. But Non-toxic goiter (an enlarged thyroid) was more than twice as common in the breast cancer patients; 45.5% of breast cancer patients had thyroid enlargement compared with only 10.5% of controls. In addition, Radiation therapy for breast cancer can be associated with development of hypothyroidism, requiring long term thyroid supplementation therapy.

Women independently have a increased predisposition to have thyroid disorders. Thyroid disorders that are common in women include - the following -

1. Hyperthyroidism (Overactivity of the thyroid gland)
2. Hypothyroidism ( Underactivity of the thyroid gland)
3. Thyroid nodules (Irregular thyroid gland growth due to fibrosis)
4. Thyroiditis (Inflammation or autoimmune conditions)
5. Thyroid cancer and
6. Goiter

By the age of 50, women can have a 50 percent chance of having a thyroid nodule larger than a half inch wide. In additions familial thyroid disorders, increase the risk and chances of having thyroid related conditions, as seen in both you and your sister. But it does not mean that you can also develop thyroid cancer like your sister, although due to the increased risk of thyroid issues getting periodically evaluated by your doctor would be helpful.

You seem to have a thyroid nodule, which could be a thyroid related lump or a secondary deposit from breast cancer.

In your case, the breast cancer (stage 0) was in very early stages and chances of metastasis would be extremely low.

In case it is a thyroid nodule, it is most likely a hypoactive, based on your thyroid function test results.

Thyroid fine-needle aspiration and biopsy is the single best method to identify malignancy in a thyroid nodule. This test can also detect if the origin of the lump in the thyroid glands is due to secondary metastasis from the breast cancer.

Based on the findings you might be advised to undergo surgery (lobectomy or Subtotal thyroidectomy - due to presence of bilateral thyroid lumps).

In case the lumps are not neoplastic (non-cancerous) in nature the surgical procedure can be postponed until you have completed your radiation therapy for breast cancer.

For additional and specific information you might consult with your treating doctor for proper counselling and treatment.

I hope this helps.

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