Do thyroid nodules need to be treated “across the board”?

  In recent years, the detection rate of thyroid nodules has been increasing. Although it is invisible and not itchy or painful, it has upset many people because of the fear that it may cause cancer. A thyroid nodule is a lump in the thyroid gland that moves up and down with the thyroid gland when you make swallowing movements. Thyroid nodules can be found in both men and women of all ages, but are more common in middle-aged women, with those over 40 years of age being the most at risk. Thyroid nodules can be solitary or multiple. They are more common in women, especially in middle-aged and older women and in young women who are stressed out. Therefore, this group of people should go to a regular hospital specialist for a physical examination once a year, and women in general should have their blood thyroid hormone levels tested every three years after the age of 35. Clinical statistics show that more than 90% of thyroid nodules are benign and should be ignored, and thyroid cancer only accounts for 5-10% of thyroid nodules. Once thyroid nodules are found, do not panic or ignore them. First of all, thyroid function tests should be performed to determine whether there is a combination of hyperthyroidism or hypothyroidism. After ruling out abnormal thyroid function, further tests should be performed to determine the benignity or malignancy of the nodule. Benign nodules do not need to be treated across the board and can be reviewed regularly; malignant nodules, of course, should be surgically removed as soon as possible.  Although thyroid surgery is becoming more and more common, the lack of a unified standard for surgical indications has led to confusion in surgical treatment. The main manifestation is that many benign nodules that were originally unnecessary for surgery are given surgical removal, which not only causes unnecessary surgical trauma, but even affects the quality of life after surgery. At present, the main judgment is to identify the benign and malignant nodules, mainly based on ultrasound and puncture biopsy, which are highly dependent on the surgeon’s skills, coupled with the fact that thyroid surgery, although not major, is risky and may lead to hoarseness if the nerves are damaged, and postoperative “cramps” if the parathyroid gland, which is the size of a green bean, is damaged during surgery. This can lead to postoperative “cramping” if the parathyroid glands are damaged during surgery. Therefore, patients are advised to see an experienced ultrasonographer and surgeon to improve the accuracy of diagnosis and receive specialized treatment.