What is thyroid cancer and how often does it occur?
Thyroid cancer is a malignant tumor arising from thyroid gland cells. Thyroid nodules are very common in the community and are mostly in the form of benign nodules. The rate of malignant nodules is only 5-10% of nodules. What is expected from radiological examinations is to distinguish suspicious nodules among the most common thyroid nodules and to reveal the presence of thyroid cancer with further examinations.
Is there a test for thyroid cancer?
Screening examinations; It is performed to reach an early diagnosis for a group of diseases or cancers that have not yet shown any clinical signs, thus reducing the disease-related mortality rates or prolonging the disease-free periods. Thyroid cancer is not seen frequently enough to require screening of the entire population. In addition, since thyroid cancer progresses slowly and has low mortality rates, the benefit of early diagnosis is not sufficient for screening the entire population.
How is thyroid cancer detected?
Thyroid cancer usually does not cause a complaint. Sometimes it can cause fast growing painful nodules on the neck. However, from time to time, benign nodules may also cause rapid size increase and pain due to bleeding or degeneration into the nodule. Ultrasonography examination to be performed together with the clinical examination is an easy and harmless imaging method for the detection of thyroid nodules.
Which nodules are suspicious and how to distinguish them?
It is tried to distinguish suspicious nodules according to ultrasonographic criteria and the size of the lesions. Evaluation of lesions and classification according to risk groups are made according to TI-RADS (Thyroid Imaging Reporting and Data System) criteria. The diagnosis and follow-up method is decided according to the scores and dimensions of the lesions.
When to biopsy thyroid nodules?
According to the TI-RADS criteria, the size limit of the lesions to be biopsied is 1 cm and above. Even if all the suspicious criteria are met, the lesions are expected to reach the 1 cm border with follow-ups in order to evaluate whether the nodules are clinically active (manifest) cancer and to avoid unnecessary treatment methods.
What is the thyroid biopsy method?
Fine needle aspiration biopsy (cytology) method is used to reach cell diagnosis of thyroid nodules. In this method, the suspicious nodule is entered with a needle under the guidance of ultrasonography and the cell is aspirated. These samples are evaluated and classified by pathologists.
What is the diagnostic value and reliability of thyroid biopsy?
Depending on the internal structure of the nodule and the technique applied, 5-10% of thyroid biopsies may be diagnostically inadequate.
Benign nodules in 60-70% and malignant tumors in 5% are detected.
Depending on the structure of the lesion and the character of the cells, a clear diagnosis may not be made at a rate of 10-20% and there may be cases in between.
How should a procedure be followed in cases where a repeat biopsy is required?
A repeat biopsy should be performed three months later to distinguish biopsy-related cellular changes from the true lesion. In doubtful cases, it may be necessary to remove the nodule surgically and to examine the whole.
Are there any complications of biopsy?
Fine-needle aspiration biopsy is not an expected procedure in general. Although it is not necessary to stop the blood thinners, due to the possibility of hematoma and swelling in the area where the procedure is performed, the drugs should be discontinued and biopsy should be performed later in cases where there is no harm in stopping the drugs for a short time. Sometimes there may be bleeding into the cystic nodules, but it does not create a dangerous result. There is no proven case for the possibility of seeding malignant cells along the needle line and can be ignored.