Nodules, or “lumps,” in the thyroid gland are quite common. Lumps that can be felt by your doctor during an examination are found in at least five percent of people. Most are benign and only fifteen percent are cancerous. There are two types of nodules:
1. "Cold nodules" -- On a thyroid scan, these do not pick up radioactive iodine and do not cause thyroid imbalance. However, these nodules are the most likely to be cancerous.
2. "Hot nodules" -- Also known as hyperactive thyroid nodules, these are much less common than cold nodules. They tend to cause hyperthyroidism and are almost never cancerous.
If your TSH levels are normal while still having a thyroid nodule, you most likely have a cold nodule. The next step should be an Ultrasound Guided Fine Needle Aspiration Biopsy. You are at a higher risk of having thyroid cancer if you've previously received radiation treatment to the neck or if you were exposed to radiation when you were a child. Men with thyroid nodules have a higher chance of having thyroid cancer than women. If your thyroid nodule size increases over time, it could be an indication that you have thyroid cancer.
New guidelines for nodules and differentiated thyroid cancer management
The American Thyroid Association has updated and revised its guidelines for managing patients with thyroid nodules and differentiated thyroid cancer. For individuals with thyroid nodules, the guidelines include ultrasound criteria, managing benign thyroid nodules, and an initial evaluation. For thyroid cancer, several new guidelines are provided pertaining to surgery management, suppression therapy, radioiodine remnant ablation, laboratory testing, and ultrasound surveillance.