As a surgical oncologist, I often have friends who take ultrasound slips to look at them, and there are often multiple thyroid nodules on the report. When you see these diagnoses, you will feel panic. Are thyroid nodules scary or not? What should I do? Should I have surgery? Will they become cancerous? A thyroid nodule is a scattered lesion caused by abnormal localized growth of thyroid cells. The prevalence of thyroid nodules obtained by palpation is 3-7%, while the prevalence of thyroid nodules obtained by high-resolution ultrasound is 20-76%. The prevalence of thyroid cancer in thyroid nodules is 5-15%. The current high prevalence of thyroid nodules can be attributed in part to our ultrasound examinations, which are getting higher and higher resolution, and with it, higher diagnostic rates. What are the causes of thyroid nodules? Current research suggests that thyroid nodules may be related to genetic factors, autoimmune diseases, radiation exposure, and exposure to iodine in the environment. Thyroid nodules can now be broadly classified into five categories: cystic nodules, inflammatory nodules, hyperplastic nodules, tumor nodules, and toxic nodular goiter. Most of these lesions are benign nodules, and only about 5-15% are malignant nodules. How is a thyroid nodule diagnosed? (1) Ultrasound examination of the thyroid gland is a must. Experienced ultrasonographers can reach a maximum diagnostic compliance rate of about 90% with the help of general ultrasound, and a higher diagnostic compliance rate when combined with ultrasonography and flexible ultrasound. If we suspect malignancy, it may be necessary to use fine needle aspiration, with the help of a small syringe, to puncture the thyroid nodule site and, if necessary, to aspirate some cells under ultrasound to further clarify the nature of the nodule through cytological pathology. ③ For some of the thyroid nodules, we may also need to use tests such as thyroid nuclear imaging, thyroid CT and thyroid function tests. Do I have to have surgery for a thyroid nodule? Our answer is no. For thyroid nodules that are considered benign, we can generally follow up and observe them. For a very small percentage of benign thyroid nodules, surgery, TSH suppression therapy, radioiodine (RAI) i.e. 131I therapy, or other treatment options such as radiofrequency therapy are available. For surgical treatment, the specific indications are (1) the presence of local pressure symptoms clearly associated with the nodule; (2) the combination of hyperthyroidism and the failure of medical treatment; (3) the location of the mass in the posterior sternum or mediastinum; and (4) the progressive growth of the nodule with clinical consideration of malignant tendency or the combination of high-risk factors for thyroid cancer. Even if it is thyroid cancer, especially microscopic thyroid cancer, if some risk factors can be excluded, to some extent, we can still observe it closely. What should I eat if I have thyroid nodules, what should I not eat and do I need to avoid eating? In general, it is not advisable to eat foods with high iodine content, such as seaweed, nori, hairy vegetables, tamari, dried scallops, razor clams, jellyfish, sea cucumber, lobster, mackerel, fish maw, ark, clam and snapper. Also avoid smoking, alcohol, stimulating foods such as coffee, strong tea, etc.; spicy stimulating foods such as pepper, chili, onion, cinnamon, etc.; fatty, greasy, fried foods. It is advisable to eat more foods with immunity enhancing, such as barley, mushrooms, shiitake mushrooms, fungus, etc.; it is advisable to eat fresh fruits and vegetables, especially ling, taro, rape, mustard, kiwi, etc. You can eat river fish, river shrimp, meat, eggs, milk, etc. It is appropriate to eat salmon, tuna, scallop, yellowtail and other sea fish. Correctly seek medical attention and reasonable diagnosis and treatment, thyroid nodules are not terrible.