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Thyroid Cancer Diagnosis

A Look at the Procedures and Tests for Diagnosing Thyroid Carcinoma

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Updated February 26, 2012

Thyroid Cancer Diagnosis

A thyroid nodule biopsy is often needed to diagnose thyroid cancer.

Diagnosis of thyroid cancer typically involves a number of procedures and tests.

Physical Exam

Your doctor should conduct a thorough physical exam, including palpation of your thyroid to feel for enlargement and lumps, as well as the gland's size and firmness. The doctor will also look for any enlarged lymph nodes in your neck.

Find out more about what is involved in a thorough clinical examination of the thyroid.

Biopsy

Doctors often biopsy suspicious thyroid nodules, to evaluate for potential cancer. Typically thyroid nodules are biopsied using a needle, in a procedure known as "fine needle aspiration biopsy" -- sometimes abbreviated FNA. Some patients have a surgical biopsy, where the nodule, or the thyroid gland itself, is removed surgically.

This Q&A on Fine Needle Aspiration Biopsy of the Thyroid has detailed information on the procedure.

A new test available since 2011, called the Veracyte Afirma Thyroid Analysis, eliminates indeterminate or inconclusive thyroid nodule biopsy results.

Imaging Tests

A variety of imaging scans are used to evaluate thyroid nodules for possible thyroid cancer. These include:
  • Nuclear scan, also known as radioactive iodine uptake (RAI-U) scan. Nodules that absorb more radioactive iodine, and therefore are more visible, are known as "hot nodules" and are more likely to be benign.
  • CT scan, known as computed tomography or a "cat scan," is a specialized type of x-ray that is sometimes used to evaluate the thyroid. A CT scan can't detect smaller nodules, but may help detect and diagnose a goiter, or larger thyroid nodules.
  • Magnetic resonance imaging (MRI), can help detect enlargement in the thyroid, as well as tumors, tumor size, and may be able to detect tumor spread.
  • Thyroid ultrasound, can tell whether a nodule is a fluid-filled cyst, or a mass of solid tissue, but it cannot determine if a nodule or lump is malignant.
More information on imaging tests for the thyroid is included in this article on Thyroid Imaging Tests.

Blood Tests

Blood tests cannot diagnose thyroid cancer itself, or detect a cancerous thyroid nodule. Thyroid stimulating hormone (TSH) blood tests, however, may be used to evaluate the thyroid's activity and test for hypothyroidism or hyperthyroidism.

When medullary thyroid cancer is suspected, doctors will typically test for high levels of calcium, as this can be an indicator. They may also do genetic testing to identify the abnormal gene associated with some cases of medullary thyroid cancer.

More Information on Thyroid Cancer

Find out more about the risk factors for thyroid cancer, and the signs and symptoms of thyroid cancer.

Sources:

Braverman, MD, Lewis E., and Robert D. Utiger, MD. Werner and Ingbar's The Thyroid: A Fundamental and Clinical Text. 9th ed., Philadelphia: Lippincott Williams & Wilkins (LWW), 2005.

National Cancer Institute -- Thyroid Cancer Page

What You Need to Know About Thyroid Cancer, National Cancer Institute

American Cancer Society: Thyroid Cancer Guide

American Cancer Society: Thyroid Cancer Statistics

Thyroid Cancer Survivors Association (ThyCa)

Mary Shomon, About.com's Thyroid Guide since 1997, is a nationally-known patient advocate and best-selling author of 10 books on health, including "The Thyroid Hormone Breakthrough: Overcoming Sexual and Hormonal Problems at Every Age," "The Thyroid Diet: Manage Your Metabolism for Lasting Weight Loss," "Living Well With Hypothyroidism: What Your Doctor Doesn't Tell You...That You Need to Know," "Living Well With Graves' Disease and Hyperthyroidism," "Living Well With Autoimmune Disease," "Living Well With Chronic Fatigue Syndrome and Fibromyalgia," and the "Thyroid Guide to Hair Loss." Click here for more information on Mary Shomon.

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