Because only a few thyroid nodules can develop into malignancy, making an unnecessary diagnosis affects patient health, and thus national incidence figures.
Dr. Jose García Mateo, former president of the Puerto Rican Society of Endocrinology and Diabetes, SPED. Photo: Journal of Medicine and Public Health.
the doctor Jose Garcia Mateothe former president of Puerto Rican Endocrinology and Diabetes Associationwarned that overdiagnosis From thyroid cancer They should be avoided, because once nodules are detected, the first option is to use aggressive treatments when research indicates that less than 10% of these lesions are malignant.
The doctor cited US endocrinology guidelines, where “it is recommended that patients with very small nodules, which could have characteristics of cancer, be diagnosed by ultrasound, and surgery should be avoided.”
Thyroid nodules are solid masses that form inside the Thyroid, a small gland located at the base of the neck. These lumps are filled with fluid, but most are not dangerous and do not cause any symptoms. Only a small percentage of these nodules are cancerous.
In fact, many thyroid patients don’t realize they have one of these nodules until a doctor discovers it during a routine examination. In other cases, these nodules can grow so large that they become noticeable, making breathing or swallowing difficult. All options, regarding treatments, will depend on the thyroid nodule the person presents with.
As mentioned earlier, these nodules do not cause symptoms, but when they are large, they may be palpable, seen as swelling at the base of the neck, pressing on the windpipe or esophagus, and causing shortness of breath or difficulty swallowing.
Causes of thyroid nodules
The reasons can be multiple, including the following:
Excessive growth of normal thyroid tissue: Or a thyroid adenoma, is not cancerous and is not considered dangerous unless it is bothersome because of its size.
Thyroid cyst: When cavities are filled with fluid. They are also not usually considered cancerous, although they sometimes contain precancerous components.
Chronic thyroiditis: Hashimoto’s disease can cause inflammation of the thyroid gland and lead to the development of large nodules; It is often associated with hypothyroidism.
Goiter nodule: It could be caused by an iodine deficiency or a thyroid disorder. These contain multiple nodules within the goiter.
thyroid cancer: Although the chances of a nodule being cancerous are very small. However, if the knot is very large and causes discomfort, it is recommended to consult a doctor.
Iodine deficiency: In this diet can cause the development of nodules in the thyroid gland. However, this reason is rare.
For the specialist is Crucial importance that the doctor Treat the patient he really needs with clear individualization treatment or treatment. “It is often said that the results of these studies, with such high statistics, are also due to overdiagnosisIt is something to be avoided.
For this reason, the endocrinologist emphasized that doctors may have another option to treat those small nodules without posing any risk to the patient’s health. In the same way, he commented that by ultrasonography, a complete evaluation of the nodule or . is made cancer Thyroid gland that needs treatment.
It is important to highlight that the clinician has been very clear about how overdiagnosis can be ineffective and affect the numbers currently available, “The ubiquity has increased, however, occasional nodules were found because they had evaluated differently to other diagnoseDr. said. Garcia.
“You have to see the reasons for the higher incidence of cancer in men and women, mostly women, which is quite impressive, and obviously we have to investigate more about it, to see if there are specific causes in this population,” he said.
Before Nodule treatment issues Thyroid or thyroid cancerThe specialist emphasized how the treatment of this condition is sought with less aggressiveness than before, however, if in some cases the treatment needs to be more aggressive, then it should be done in this way.
On the other hand, Dr. Garcia pointed out that there is no prevention of thyroid problems and autoimmune diseases, but he highlighted the importance of early diagnosis and prevention of complications that can develop from this disease.
For an early diagnosis of this condition, a physical examination is recommended, which is done as follows: “The thyroid gland is H-like and palpable, then it moves back, up and down palpation, after swallowing, and when the gland is raised, the volume can be palpated, without touching the edges.”
Currently, there are risk factors in the Puerto Rican population, such as obesity and insulin resistance, “because this can increase the likelihood of developing malignancies, however, it is recommended that the health system be used for early diagnosis,” the specialist commented.
It is crucial, as the expert pointed out, that if an abnormality or risk factor is present, a good prognosis is made for the patient, through physical examination and history, so that an ultrasound can be done to detect the affected node and give it its own treatment.
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