Less than 10% of thyroid nodules are malignant, Dr. García

Because only a few thyroid nodules can develop into malignancy, making an unnecessary diagnosis affects the patient’s health and, in turn, national incidence figures.

Dr. José García Mateo, past president of the Puerto Rican Society of Endocrinology and Diabetology, SPED. Photo: Journal of Medicine and Public Health.

Dr. José García Mateo, past president of the Puerto Rican Society of Endocrinology and Diabetology, warned that overdiagnosis of thyroid cancer should be avoided, since once nodules are detected, the first option is to use aggressive treatments when research indicates that fewer 10% of these lesions are malignant.

The doctor cited the endocrinology guidelines of the United States, where “patients who have very small nodules, which could have characteristics of cancer, are recommended to be diagnosed with sonography, and avoid surgery.”

Thyroid nodules are solid lumps that form inside the thyroid, the small gland located at the base of the neck. These lumps are filled with fluid, but most aren’t serious, and they don’t cause any symptoms. Only a small percentage of these nodules are cancerous.

In fact, many thyroid sufferers don’t realize they have one of these nodules until their doctor discovers it during a routine exam. In other cases, these nodules can grow so large that they become noticeable, making it difficult to breathe or swallow. All the options, in terms of treatments, will depend on the thyroid nodule that the person presents.

As mentioned, these nodules do not cause symptoms, but when they are large, they may be palpable, seen as swelling at the base of the neck, press on the trachea or esophagus, and cause shortness of breath or trouble swallowing .

Causes of thyroid nodules

The causes can be several, including the following:

Excessive growth of normal thyroid tissue: or thyroid adenoma, is not cancerous and is not considered serious unless it is bothersome because of its size.

Thyroid cyst: when the cavities fill with fluid. They are also not usually considered cancerous, although they do occasionally contain cancerous components.

Chronic inflammation of the thyroid: Hashimoto’s disease can cause inflammation in the thyroid and lead to large nodules; it is often associated with hypothyroidism.

Multinodular goiter: it can be caused by an iodine deficiency or a thyroid disorder. These contain multiple nodules within the goiter.

Thyroid cancer: although the chances of a nodule being cancerous are very slim. However, if the nodule is very large and causes discomfort, it is recommended to check with the doctor.

Iodine deficiency: in the diet; this can cause the thyroid gland to develop nodules. However, this cause is rare.

For the specialist it is crucial importance that the doctor treat the patient who really needs it with a clear individualization of treatment. “Many times it is said that the results of these studies, with such high statistics, are also due to overdiagnosis, which is something that should be avoided.”

For this reason, the endocrinologist emphasized that doctors may have another option to treat those small nodules without posing any risk to the patient’s health. Similarly, he commented that through sonography, a complete evaluation of thyroid nodules or cancer that needs treatment can be done.

It is important to highlight that the doctor was very clear about how overdiagnosis can be inefficient and affect the figures that are currently available, “the prevalence has increased everywhere, however, incidental nodules were found because they made a different evaluation for another diagnosis, most of these nodules are not an emergency,” said Dr. García.

“You have to see the causes that led to this high incidence of cancer in men and women, mostly in women, which is impressive, and obviously we have to investigate more about it, to see if there are specific causes in this population,” he said. .

before the nodule treatment issues thyroid or thyroid cancerthe specialist emphasized how this condition is sought to be treated with less aggressiveness than before, however, if in some cases the treatment needs to be more aggressive, it should be done that way.

On the other hand, Dr. García mentioned that there is no prevention for thyroid problems and autoimmune conditions, however, he highlighted the importance of early diagnosis and prevention of complications that can develop from this disease.

For the early diagnosis of this condition, the physical examination is recommended, which proceeds as follows: “the thyroid gland is like an H and is palpated, then it goes backwards, up and down palpating, after swallowing, and when raising the gland the size can be palpated, without palpating the edges”.

Currently, there are risk factors in the Puerto Rican population, such as obesity and insulin resistance, “because this can increase the probability of malignancy, however, it is recommended to use the health system for a diagnosis sooner from the condition”, commented the specialist.

It is of vital importance, as indicated by the expert, that in the event of an anomaly or risk factor, a good diagnosis of the patient is carried out, through physical examination and history, so that a sonography can be done to detect the affected nodule. and give him his respective treatment.

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