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*Read only for medical professionals Reference Can a benign nodule end up cancerous? Will the nodules continue to grow, will the risk of cancer become higher and higher? What changes to merge require extra attention? In recent years, the detection rate of thyroid nodules has increased year by year
.
Although 90% of nodules are benign, many people still experience greater psychological stress
.
Especially when thyroid nodules are found in the annual physical examination, many friends will inevitably worry about these questions: Will benign nodules eventually become cancerous? Many thyroid patients think that the thyroid tissue first becomes a benign nodule, and then gradually evolves into thyroid cancer
.
In fact, studies have shown that thyroid cancer tends to develop directly from normal thyroid tissue to thyroid cancer
.
That is to say, the genetic mutation sites and processes of malignant tumors are completely different from benign lesions and hyperplasia from the beginning, and the subsequent evolution will basically not overlap or overlap with each other
.
In layman's terms, it's not that your big nodules have gotten worse, but your bad nodules have gotten bigger! A study showed that after 5 years of follow-up of 992 patients with asymptomatic benign thyroid nodules, it was found that most of the patients' benign nodules did not show significant enlargement, and the number of nodules developed into cancer was also very small.
, only 0.
3% of benign nodules were cancerous
.
Therefore, patients diagnosed with benign thyroid nodules do not need to worry too much, and regular review can be done (provided that the nodules must be benign)
.
Are nodule growth proportional to cancer risk? The growth rate of nodules is affected by many factors
.
Such as the type of nodule, whether it is a single nodule or multiple nodules; whether there is iodine deficiency; the anatomical characteristics of nodules,
etc.
In some patients, the nodules are diagnosed as benign, but they have been growing, so they are very worried
.
Research data shows that this happens in 20% to 39% of patients
.
Compared with the elderly, young and middle-aged patients with benign nodules are more likely to enlarge
.
The higher the body mass index (BMI), the more likely it is that benign nodules will grow as weight increases
.
At the same time, some studies have found that if a benign nodule is simply enlarged, or even a benign nodule grows rapidly in a short period of time, such as a 50% increase in volume within 6 months, but its structural characteristics have not changed significantly, then the general Cancer does not occur
.
As shown in the figure below, this study covered 2463 patients with nodules: 12.
7% of nodules with a volume of less than 5cm³ were finally confirmed to be malignant, which was much higher than 7.
8% of the nodules with a volume of more than 10cm³
.
Image source: Nagihan Bestepe, Didem Ozdemir; Is thyroid nodule volume predictive for malignancy? Arch Endocrinol Metab.
2019;63/4 The result seems to be that the larger the nodule, the safer it is.
Does it surprise everyone? However, further studies on nodules over 10 cm³ found that the average volume of malignant nodules was significantly higher than that of benign nodules at this stage
.
It can also be understood that after the nodule size exceeds a certain cut-off value, the growth rate of malignant nodules is significantly higher than that of benign nodules
.
So, the size of the nodule alone is not a reliable basis for judging the risk of cancer! Thyroid patients can continue to maintain regular follow-up visits, don't worry too much
.
What situations need to be vigilant about merging? When the following signs begin to appear in the color Doppler ultrasound report, it is worthy of high vigilance for thyroid patients, and it is necessary to ask the doctor to make a clear diagnosis: calcification in the nodule, especially the manifestation of microcalcification, the specificity of diagnosing malignant nodules is significantly increased; If the boundary is clear or blurred, it is necessary to consider whether there is the possibility of tumor invasion; if it is a solid structure, especially hypoechoic, the malignancy may be too large
.
Of course, the continued growth of benign nodules can also be combined with other hazards
.
If the nodule grows too fast and the nodule is too large, it may compress the esophagus, trachea, and nerves, resulting in corresponding symptoms such as dysphagia, choking, dyspnea, and hoarseness
.
When these situations arise, you should contact your doctor as soon as possible and consider options such as surgery
.
If you still have any questions about the growth of thyroid nodules and the risk of cancer, you can leave a message below to tell us ~ References: [1]TunbridgeWM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, et al.
The spectrum of thyroid disease in a community: TheWhick-ham survey.
Clin Endocrinol (Oxf).
1977;7:481-93.
[2]Tan GH, Gharib H.
Thyroid incidentalomas: Management ap-proaches to nonpalpable nodules discovered incidentally on thy- roid imaging.
Ann Intern Med.
1997;126:226-31.
[3]Guth S,Theune U, Aberle J, Galach A, Bamberger CM.
Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination.
Eur J Clin Invest.
2009;39:699-706.
[4]American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and DifferentiatedThyroid Cancer, Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al.
al.
Re-vised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer.
Thyroid.
2009;19(11):1167-214.
.
Although 90% of nodules are benign, many people still experience greater psychological stress
.
Especially when thyroid nodules are found in the annual physical examination, many friends will inevitably worry about these questions: Will benign nodules eventually become cancerous? Many thyroid patients think that the thyroid tissue first becomes a benign nodule, and then gradually evolves into thyroid cancer
.
In fact, studies have shown that thyroid cancer tends to develop directly from normal thyroid tissue to thyroid cancer
.
That is to say, the genetic mutation sites and processes of malignant tumors are completely different from benign lesions and hyperplasia from the beginning, and the subsequent evolution will basically not overlap or overlap with each other
.
In layman's terms, it's not that your big nodules have gotten worse, but your bad nodules have gotten bigger! A study showed that after 5 years of follow-up of 992 patients with asymptomatic benign thyroid nodules, it was found that most of the patients' benign nodules did not show significant enlargement, and the number of nodules developed into cancer was also very small.
, only 0.
3% of benign nodules were cancerous
.
Therefore, patients diagnosed with benign thyroid nodules do not need to worry too much, and regular review can be done (provided that the nodules must be benign)
.
Are nodule growth proportional to cancer risk? The growth rate of nodules is affected by many factors
.
Such as the type of nodule, whether it is a single nodule or multiple nodules; whether there is iodine deficiency; the anatomical characteristics of nodules,
etc.
In some patients, the nodules are diagnosed as benign, but they have been growing, so they are very worried
.
Research data shows that this happens in 20% to 39% of patients
.
Compared with the elderly, young and middle-aged patients with benign nodules are more likely to enlarge
.
The higher the body mass index (BMI), the more likely it is that benign nodules will grow as weight increases
.
At the same time, some studies have found that if a benign nodule is simply enlarged, or even a benign nodule grows rapidly in a short period of time, such as a 50% increase in volume within 6 months, but its structural characteristics have not changed significantly, then the general Cancer does not occur
.
As shown in the figure below, this study covered 2463 patients with nodules: 12.
7% of nodules with a volume of less than 5cm³ were finally confirmed to be malignant, which was much higher than 7.
8% of the nodules with a volume of more than 10cm³
.
Image source: Nagihan Bestepe, Didem Ozdemir; Is thyroid nodule volume predictive for malignancy? Arch Endocrinol Metab.
2019;63/4 The result seems to be that the larger the nodule, the safer it is.
Does it surprise everyone? However, further studies on nodules over 10 cm³ found that the average volume of malignant nodules was significantly higher than that of benign nodules at this stage
.
It can also be understood that after the nodule size exceeds a certain cut-off value, the growth rate of malignant nodules is significantly higher than that of benign nodules
.
So, the size of the nodule alone is not a reliable basis for judging the risk of cancer! Thyroid patients can continue to maintain regular follow-up visits, don't worry too much
.
What situations need to be vigilant about merging? When the following signs begin to appear in the color Doppler ultrasound report, it is worthy of high vigilance for thyroid patients, and it is necessary to ask the doctor to make a clear diagnosis: calcification in the nodule, especially the manifestation of microcalcification, the specificity of diagnosing malignant nodules is significantly increased; If the boundary is clear or blurred, it is necessary to consider whether there is the possibility of tumor invasion; if it is a solid structure, especially hypoechoic, the malignancy may be too large
.
Of course, the continued growth of benign nodules can also be combined with other hazards
.
If the nodule grows too fast and the nodule is too large, it may compress the esophagus, trachea, and nerves, resulting in corresponding symptoms such as dysphagia, choking, dyspnea, and hoarseness
.
When these situations arise, you should contact your doctor as soon as possible and consider options such as surgery
.
If you still have any questions about the growth of thyroid nodules and the risk of cancer, you can leave a message below to tell us ~ References: [1]TunbridgeWM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, et al.
The spectrum of thyroid disease in a community: TheWhick-ham survey.
Clin Endocrinol (Oxf).
1977;7:481-93.
[2]Tan GH, Gharib H.
Thyroid incidentalomas: Management ap-proaches to nonpalpable nodules discovered incidentally on thy- roid imaging.
Ann Intern Med.
1997;126:226-31.
[3]Guth S,Theune U, Aberle J, Galach A, Bamberger CM.
Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination.
Eur J Clin Invest.
2009;39:699-706.
[4]American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and DifferentiatedThyroid Cancer, Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al.
al.
Re-vised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer.
Thyroid.
2009;19(11):1167-214.
