Upon seeing the words "thyroid nodules" on their physical examination report, many people will immediately fall into a "cancer panic".
Regarding this, Cheng Jiajia, Deputy Director of Minimally Invasive Surgery at Hainan Chengmei Hospital, stated that most thyroid nodules do not require special treatment. Even if intervention is necessary, there are minimally invasive solutions that can avoid the drawbacks of traditional surgery. Scientific response is the key.
Over 90% of thyroid nodules are benign
Many people tend to associate "nodules" with cancer, which is a typical misconception. According to clinical data, only 5% to 10% of thyroid nodules are malignant, indicating that over 90% of thyroid nodules are benign and pose no threat to health, thus not requiring excessive intervention.
Even if one is unfortunately diagnosed with malignant thyroid nodules, there is no need to panic. Most thyroid cancers (such as the common papillary cancer) are of low malignancy. After standard treatment, the 5-year survival rate can exceed 95%. Patients can still lead a normal life and work after surgery, with minimal impact on their overall health. There is no need to bear an excessive psychological burden due to the label of "cancer".
Ultrasound + puncture to differentiate benign from malignant
How to accurately determine the benignity or malignancy of thyroid nodules? Ultrasound examination is a crucial first step in screening for thyroid nodules. Through the description of characteristics in the ultrasound report, the nature of the nodules can be preliminarily determined.
Benign nodules often exhibit cystic or spongy changes, clear boundaries, and no blood flow signals. For example, nodular goiter with a diameter less than 2 cm generally requires no special treatment and can be regularly rechecked. However, if ultrasound reveals features such as unclear boundaries, punctate strong echoes, and an aspect ratio greater than 1, it indicates that the nodule may have malignant risks and further examination is necessary.
Thyroid fine-needle aspiration biopsy is the "gold standard" for determining the benignity or malignancy of nodules. For nodules with malignant tendencies indicated by ultrasound, a small amount of nodule tissue is extracted through fine-needle aspiration for pathological analysis, which can accurately determine the benignity or malignancy. If the result is "suspicious of malignancy", close follow-up or timely intervention is required; if it is benign, it can be managed as a benign nodule.
Minimally invasive ablation bids farewell to "one-size-fits-all" approach
In the past, some patients opted for traditional open surgery due to nodule compression or concerns about canceration. This approach not only left scars on the neck but also had the potential to damage nerves, resulting in hoarseness.
The ultrasound-guided radiofrequency ablation of the thyroid performed by the minimally invasive surgery department at Hainan Chengmei Hospital has the greatest advantage and characteristic compared to traditional open surgery, which is its minimally invasive nature - no need for surgery, no significant pain during the procedure, and no scars left after surgery, making it a more friendly solution for thyroid nodules.
Cheng Jiajia explained that this technology utilizes real-time ultrasound guidance to insert 1-2 millimeter ablation needles into nodules, using energy to coagulate and necrose the nodular tissue, which is then absorbed by the body. Compared to traditional surgery, it offers significant advantages: the millimeter-sized needle puncture requires no suturing, and a band-aid is sufficient post-operation; it causes minimal trauma, preserves thyroid function, and avoids long-term postoperative medication; and it shortens hospitalization time, allowing patients to be discharged within 1-2 days.
Regular follow-up is crucial
Regardless of whether a nodule is benign or malignant, regular follow-up is the core of health management. For benign nodules with a diameter of less than 2 cm, ultrasound examination should be conducted once a year; for those ranging from 2 to 4 cm, follow-up should be conducted every 6 to 12 months; if the nodule grows by more than 20% in half a year or presents with compression symptoms, ablation or surgery may be considered.
For suspicious malignant nodules, puncture is required first. If the result is benign, follow-up as per benign cases. For suspicious cases, reexamination is needed every 3-6 months. For malignant cases, a comprehensive treatment plan should be formulated as soon as possible. After ablation surgery, patients should return for reexamination at 1 month, 3 months, 6 months, and 12 months. If there is no abnormality after 1 year, the examination can be changed to annual.
Expert Introduction
Cheng Jiajia Master's degree candidate
Deputy Director of Minimally Invasive Surgery
Medical expertise: Specialized in the standardized diagnosis and treatment of thyroid diseases, skilled in minimally invasive treatment of thyroid tumors and comprehensive treatment of advanced thyroid tumors.
Article | Huang Fei