1cm Dense Thyroid Cyst! Do I have a 2nd cancer? Do I care?
I have a 1cm dense cyst with vascularation (?) (the thing has blood vessels) in the right lobe of my thyroid. It's showed up as hypermetabolic in my PET scans since last April. I finally bothered to get a better look at it with ultrasound yesterday. Radiologist says that since it hasn't grown on the PET scans in a year and, since I get regular PET scans, monitoring is a reasonable option. So is biopsy. My choice. But if it is cancer, they are going to recommend an operation to remove it.
The thyroid is an unlikely place for MBC to metastasize, so if it is cancer, it is probably a new primary. Radiologist wasn't sure it was cancer. Only biopsy can tell.
This doesn't really belong in this forum or even in a breast cancer forum, but you all have my back so I thought I would put it out here. Anyone know anything about thyroid cancer?
I am oddly blase about this, but my complementary onc gave me a stern direction to deal with it. The way he said it was "Get this checked out and make sure that the endocrinologist knows that you are not going to die of MBC, because you are doing well. I want them to treat this like you were otherwise healthy." I liked that, but tired of dealing with medical issues and somehow not concerned, and therefore unmotivated, to fight this new front.
Interested in your thoughts.
>Z<
Comments
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I have twice had thyroid growths in the past, one was removed and one monitored. Biopsies all benign. I take thyroid meds. I think the second one grew because of eating goitrogenic broccoli sprouts daily for three months. Mass started shrinking after I cut down on broccoli and co.
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Z, hmmm hard decision isn't it. A part of me wants to say just keep monitoring it by pet scan, if it hasn't changed in a year, that is a good sign. But then the other part of me thinks I would have to have a biopsy, just to know. If you had the biopsy and it was benign, then you don't have to worry about it anymore. Which for me, would be a good thing. If you went that route, a biopsy isn't bad. They typically do them by ultrasound guidance and numb it really good so you can't feel it. Of course if the biopsy was positive then you would have to proceed with surgery. But that would be a good thing too cause then it would be taken care of. So, I think I would have to proceed with the biopsy and see what happens. Wishing you the best, and for this to be just a benign nuisance. Enjoy the moment
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Hi Z, I had a thyroid scare a few years back and the doctor told me if you could choose your cancer, thyroid would be it as it is almost always completely curable. The mass turned out to be benign and was removed as apparently it could interfere with swallowing etc. It was a really easy procedure (from my perspective). I'm not taking any thyroid meds.
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Z - I have a hypermetabolic thyroid nodule that showed up on a PET scan as part of complete screening at dx. Biopsy showed Hurthle cells, rather rare. With only a biopsy on this type of cells, they cannot determine if it's malignant or not, only complete removal tells it all. I was given the option of surgery/removal but in the end both doc and I decided to leave it alone and monitor. Still stable about 3 years later.
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Sigh. As Rosanna Rosanna Danna (Gilda Radner) said, "It's always something." When a doctor or dentist recommends another test, it's all I can do not to say, "Get in line." I still have not scheduled that stupid screening colonoscopy, and there are at least three other non-bc things on the waiting list. But I am busy living life and pacing myself so I don't get too worn out dealing with bc. I guess if I were in your position, a biopsy would go to the top of my non-bc medical to-do list, but I would schedule it at a time that is convenient and less likely to interfere with stuff I want to do. If no biopsy, then I would ask about having a second PET in six months rather than a year.
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I have had thyroid nodules for many years. I have been both hyper and hypo thyroid. I took Synthroid for years nut had radioactive iodine tx, well over 10 years ago, and all was well. My PET last fall showed some metabolic activity in the same area as years ago, so had a fine needle biopsy which showed it was benign, so just monitoring. Mets to the thyroid from bc seems to almost never happen. As for it being new primary, my endocrinologist also said that thyroid cancer would not be cause for huge worry,,but I understand not wanting anymore medical anything! Take care.
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zarovka, I'm sorry to hear about another thing being added to your plate, although hopefully this'll turn out to be nothing.
From what I've researched, it is very rare for mbc to spread to the thyroid, although there have been some cases reported. Most likely this is benign, as others here have experienced. But if it is thyroid cancer, it's best to know about it and go from there. One of my friends was diagnosed decades ago with thyroid cancer and has been fine ever since.
Hopefully all is well, but it may be best to make certain and have peace of mind.
Sending you a warm hug!
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I would do the biopsy. I have had my thyroid removed due to Grave's Disease. Didn't really have a choice. It wasn't a horrible surgery, though it was really weird when he drew that line across my neck. It was a real Sweeney Todd moment.
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Two friends have had thyroid cancer. Both times the docs just removed the thyroid and they take Synthroid. The surgeries seemed relatively easy, though one of them had frozen vocal cords for a while.
How aggressive are you feeling? There is a third option. You can have the biopsy. If not cancer fine. If cancer you can still opt for watchful waiting. Don't have to remove it until/unless you are ready for the OR.
Personally I'd do nothing. If it hasn't grown in a year it probably won't grow enough to be a problem in the next year.
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Heidi - My 11 year old daughter will be thrilled to hear broccoli can be bad for you. I've pitched broccoli as the ultimate prize in the quest for an improved diet ... she is sincerely trying and is cautiously bonding with lettuce this month. I don't think I am going to tell her.
Thank you all. Your responses confirm my hunch that thyroid cysts, even dense vasculated cycsts are often benign. I mis-typed in my top post. I get PET scans every 4-6 months, so it seems like a reasonable monitoring plan. I have an appointment with a new Endo in May. I will run this all by him. I will get a biopsy if he wants one. But I don't feel, from reading your posts that I need to get too wound up even it it is cancer.
Isn't it amazing how inured to this stuff we become? I know this would have put me over the edge two years ago, so I needed a sanity check from you guys. Thanks.
>Z<
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Ask your oncologist about this. Have a thorough work up of thyroid labs. If it isn't bothering you, and you are ok with it, avoid biopsy. I have had a thyroid module for 4 years. I had a biopsy that showed it was cancerous, and had no treatment. It has shrunken slightly over that time.
I regret that biopsy because it puts me out of consideration for any trials. This is the biggest point I want to make.
It doesn't affect my thyroid function (as far as blood tests go). Only you can decide, but talk it over with your family and doctor. Best wishes to you.
Most thyroid cancers are extremely slow growing, and I was told I probably had it for years before the biopsy
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Snowflake - Holy cow. I have a number of trials on my radar. Your comment about being excluded from clinical trials is a very important point. Thanks.
And if we're going to monitor even if it is cancerous, definitely no point to a biopsy.
I will discuss this with the endo (oncologists declined to advise) but you've pointed out two issues that really matter. Thank you again.
>Z<
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Whoa, good point Snowflake.
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Yikes! I just had a biopsy of my thyroid last Monday. Fortunately, my large nodule that has had mild SUV uptake on PET/CT for the last year came back negative for cancer. I was told that if my thyroid was cancerous, it would most likely be thyroid cancer and not breast cancer mets. I had no idea that a diagnosis for breast cancer could affect my eligibility for future breast cancer trials!!! Thanks for alerting us to that risk, Snowflake!
Z - The fine needle biopsy was similar to a breast fine needle biopsy. The endocrinologist biopsied it in his office after doing an ultrasound. He told me that based on what he saw on the ultrasound, he did not think that I had thyroid cancer. Maybe your endocrinologist can tell you more just based on an ultrasound, although only a biopsy can tell for sure. By the way, I was also strangely not particularly concerned about thyroid cancer, even before the doctor told me that he did not think it was likely. Stage IV breast cancer trumps thyroid cancer... Still, I'm very happy that I don't have another cancer to treat!!
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Oops! I meant to say that I had no idea that a diagnosis of thyroid cancer could affect my eligibility for breast cancer trials. It's late! Theresa
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thanks very much Theresa. I think if I do a biopsy I will do it in Canada and pay out of pocket so I don't have to put the results in my formal record. The clinical trial issue is very serious as I may need immunotherapy before it is approved.
The cyst is actually .8cm which some feel is too small to biopsy. Will monitor for now.
Z
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