In the ultrasound report of thyroid nodules or breast nodules, the nodules are often classified, and the standard term should be classification rather than grading. Category 5 thyroid nodules are usually defined as nodules with typical signs of malignancy or even metastases in the lymph nodes of the neck. 5 nodules have a 95% chance of being malignant and can be considered as thyroid cancer. The higher the level of the doctor, the more accurate the classification is, but the classification only represents the probability of malignancy, the final diagnosis still needs pathological diagnosis, so there are also nodes in category 5 that are diagnosed as benign by puncture, this is usually seen in zombie nodes. Prior to surgery, the physician will usually recommend a needle aspiration cytology biopsy, abbreviated as FNA, which is usually required for a category 4 nodule. If the diagnosis of thyroid cancer is confirmed by FNA, the patient can undergo surgery or ablation treatment as appropriate, and even some small malignant nodules can be reviewed periodically without delay. Even if the nodules are diagnosed as category 5 by ultrasound, patients still do not need to be overly nervous because most of thyroid cancer is papillary cancer, which is an inert cancer and does not have serious impact on human life, provided that it is closely observed and treated in time once there is any change. If surgery or ablation treatment is decided, it is better to have a needle aspiration cytology biopsy before surgery to obtain the support of pathological diagnosis.