Nodules on the thyroid are often discovered through routine physical exams. Occasionally, a patient might find a nodule as a small lump in the neck. If a thyroid nodule is detected, your doctor will ask about your personal and family medical history and will feel your neck for lumps or swelling. You also will likely have one or more of the following tests:

Blood Tests - These check for abnormal levels of TSH (thyroid-stimulating hormone) in the blood. Levels that are too high or too low indicate the thyroid isn’t functioning properly.

Ultrasound - Sound waves and a computer are used to create a picture of thyroid nodules that are too small to be felt. This test shows the size and shape of the nodule and whether it is solid or filled with fluid. Solid nodules could be cancerous.

Thyroid Scan - The patient swallows a small amount of radioactive substance. Thyroid cells that absorb this substance can be seen on a scan. If a nodule takes up more of the substance than the tissue around it, it is a “hot” nodule. If a nodule takes up less substance than tissue around it, it is “cold.” Hot nodules are usually not cancer, but cold nodules could be.

Biopsy - A pathologist looks at a sample of tissue from the nodule under a microscope to check for cancer cells. This test is the only sure way to diagnose thyroid cancer. It can be done in two ways, either through fine needle aspiration or a surgical biopsy.

Fine Needle Aspiration: A thin needle is used to remove a sample of tissue from the nodule. Most people have this type of biopsy.

Surgical Biopsy: If a diagnosis can not be determined from a fine needle aspiration, a surgeon removes the nodule from the thyroid during an operation. This is often done if a doctor suspects follicular thyroid cancer.

Once the results from the test or procedure are returned you will be able to make thoughtful decisions. Please see Newly Diagnosed for information on being patient active, treatment decisions, partnering with your healthcare team and finding support.

Receiving a cancer diagnosis is difficult. Please see Caregivers and/or Online Support for more information on how the Cancer Support Community can offer support.

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