”What do you do when you find a lump on your body? Surgery, of course.” Many people think they have cancer when they find a thyroid nodule in their physical examination, and they want to have surgery immediately. Are all thyroid nodules cancerous? Do they all need to be operated? Thyroid nodules prefer women. Thyroid nodules are a common disease; improper iodine supplementation, stressful life and environmental factors can lead to thyroid hormone abnormalities, which can cause thyroid disease. Thyroid nodules are divided into palpable nodules and non-palpable nodules. Palpable nodules are easy to detect, and are mostly found by patients unintentionally or by doctors during physical examinations, while non-palpable nodules are usually found during ultrasound examinations or accidentally when examining adjacent parts of the thyroid gland. Studies have shown that 5% of women and 1% of men in the general population have palpable thyroid nodules. The prevalence of non-palpable nodules can be as high as 20% or higher. Thyroid nodules are more prevalent in women, and 40-50% of young and middle-aged women are found to have thyroid nodules by ultrasound. In fact, the term “nodule” is only a description of the form, and lumps in the thyroid gland are collectively called thyroid nodules. Degenerative changes of the thyroid gland, hyperthyroidism, thyroid inflammation, autoimmune diseases, thyroid adenomas, nodular goiter and thyroid cancer can all be manifested as multiple or single nodules on the thyroid gland. According to the results of clinical surveys in recent years, 95% of thyroid nodules detected are benign lesions. Some of these nodules can subside on their own, and some inflammatory nodules can be significantly reduced by improving lifestyle habits and taking medications as prescribed by the doctor. If a nodule is found to be substantial, with irregular borders, calcification and a rich blood supply, then the possibility of a malignant nodule cannot be ruled out and early surgery is required. In order to avoid delaying the disease. In addition, if abnormal lymph nodes are found in the neck at the same time as the thyroid nodules, and if the nodules increase rapidly in size within a short period of time, and if symptoms of pressure such as hoarseness and difficulty in swallowing and breathing appear, the nodules should also be considered malignant, and surgery is still the main and effective method. Men older than 40 years of age, or those with a prior history of neck radiation, and those with a family history of thyroid cancer are also at high risk for malignant thyroid nodules and should be given due attention. For multiple thyroid nodules less than 25px in diameter, if ultrasound and CT examinations do not reveal fine calcification, microcalcification or sand-like calcification, and the mass is predominantly cystic in nature, and there are no symptoms of hyperthyroidism, only regular ultrasound follow-up is required, and surgery may not be performed if the nodule remains unchanged. In addition, surgery should be considered in the following cases: large masses with symptoms of pressure such as dysphagia and dyspnea; high-functioning adenomas with hyperthyroidism; nodules that affect the aesthetics, work and life; nodules with a tendency to become malignant. One of the most important pre-operative tests for thyroid nodules is the fine needle aspiration cytology test. This test is mildly invasive and can make a preliminary determination of the nature of the thyroid nodule with an accuracy rate of 60-70%. Many patients believe that puncture can cause thyroid nodules to become malignant or that malignant nodules can metastasize, but this is actually a very wrong belief. Fine needle aspiration cytology has only minor complications such as bleeding, and the incidence is very low, and once it occurs, it is easier to deal with, but the test results are very helpful in determining the condition. Once thyroid nodules are found, neither panic nor ignore or blindly use medication; first of all, you should go to an endocrinologist for thyroid function tests to determine whether there is a combination of hyperthyroidism or hypothyroidism, and after excluding abnormal thyroid function, further tests to determine the benignity or malignancy of the nodules. One of the main reasons why we do not advocate blind surgery to remove nodules is because of the difficulty of thyroid surgery, the abnormal abundance of blood vessels around the thyroid gland and the number of organs involved, the risk of accidental injury to blood vessels or nerves during surgery, which can have irreversible consequences for the patient; in addition, if the thyroid gland is excised too much, it can also lead to postoperative hypothyroidism and affect the health of the patient.