Thyroid nodules can be diagnosed as two primary forms, malignant (cancerous) or benign (non-cancerous). This diagnosis is one of the most significant factors considered before a suitable method of treatment is prescribed.
Is it necessary to surgically remove thyroid nodules?
According to the American Thyroid Association (ATA), over 80% of thyroid nodules are non-cancerous (benign)2. Typically, non-cancerous nodules do not need any interventions unless they are symptomatic or causing cosmetic issues. These symptoms can include difficulty breathing or swallowing and pressure in the neck. Benign thyroid condition can be treated without surgery using conservative treatment or minimally invasive options such as Radiofrequency Ablation (RFA) or Percutaneous Ethanol Ablation (PEI)5.Surgical removal of the benign nodule might also be suggested by your doctor, depending on the size or tissue composition. Regardless of which treatment option you choose, continuous checkups will be necessary to ensure the condition is not recurring.
Malignancy (cancer) is the primary indication for surgical removal of the thyroid gland. Fortunately, most thyroid cancers respond well to treatment, with a low mortality rate of 4%-8% in 20 years7. Common indications for surgery include:
- A nodule that is highly suspicious for cancer
- A diagnosis of thyroid cancer
- Symptomatic nodule or goiter – compression of the trachea (windpipe), difficulty swallowing, a visible or unsightly mass
- Thyrotoxicosis caused by an Autonomously Functioning Thyroid Nodule (AFTN) overproducing thyroid hormones
If your thyroid nodule meets any of these above conditions, your doctor may recommend thyroid surgery.
Types of Thyroid Surgery:
- Hemithyroidectomy: This involves removing one lobe of the thyroid. A doctor may recommend this surgery if a nodule or low-risk thyroid cancer is limited to one side of the thyroid1
- Lobectomy: This involves the removal of one lobe and the isthmus (bridging tissue between the two lobes of the thyroid gland)
- Isthmusectomy: This surgery removes the isthmus. Small tumors on the isthmus may only require an isthmusectomy.
- Total thyroidectomy: This involves removing the entire thyroid gland. Some cases of thyroid cancer, bilateral thyroid nodules, and Graves’ disease require a total thyroidectomy.
Not all thyroid conditions can be treated conservatively. Some conditions need surgical removal, while others can be treated minimally invasively. Knowing your condition through the right diagnosis will help you make the right decision for your thyroid issues. Have questions about your thyroid nodules? Speak to a specialist today to explore your options.
