Will thyroid cancer spread if surgery is not performed immediately after a biopsy?

Written by Yan Chun
Oncology
Updated on September 03, 2024
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Thyroid cancer, after undergoing a fine needle biopsy, may spread if surgery cannot be performed immediately, which is a risk of the thyroid cancer biopsy. Fine needle biopsy of the thyroid is a method for obtaining histopathological results and is a gold standard for the clinical diagnosis of thyroid cancer. A biopsy is an invasive examination that causes some degree of harm to the body, hence, informed consent must be obtained from the patient before proceeding. After the biopsy, complications such as local bleeding, swelling, pain, and infection may occur, and the spread of cancer cells at the biopsy site is a significant adverse effect. Therefore, for most thyroid cancer patients, it is advisable to arrange surgery as soon as possible after a biopsy to prevent the disease from spreading.

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Is thyroid swelling malignancy the same as thyroid cancer?

Thyroid malignancy refers to thyroid cancer, but even malignant thyroid cancer generally has a good prognosis. However, it is crucial to achieve early detection, diagnosis, and treatment. It is advised to promptly visit a thyroid specialty department for comprehensive examinations, including thyroid ultrasound, evaluation of thyroid function, and related thyroid antibodies. A fine needle aspiration biopsy should be conducted for a clear pathological diagnosis, followed by immediate active treatment, primarily surgical. Thyroid cancer includes papillary thyroid cancer, follicular thyroid cancer, medullary thyroid cancer, and undifferentiated cancer. The surgery mainly involves minimally invasive and traditional methods. Post-surgery, it is recommended to perform lymph node dissection, assess the extent of metastasis, and decide whether to proceed with Iodine-131 radiotherapy. Due to the loss of thyroid function, proactive thyroid hormone replacement therapy is advised, along with dynamic monitoring of thyroid health through ultrasound and related examinations.

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Symptoms of thyroid cancer

The symptoms of thyroid cancer, the first point is the clinical manifestations of differentiated thyroid cancer. Most differentiated thyroid cancers are asymptomatic, with only occasional palpable nodules of varying sizes and textures, which can sometimes be detected in routine physical and imaging examinations. A few advanced thyroid cancers may produce noticeable symptoms due to large nodules or invasion of surrounding organs, such as compression of the trachea causing breathing difficulties, difficulty swallowing due to pressure on the esophagus, and hoarseness due to compression of the recurrent laryngeal nerve. The second point concerns the specific clinical manifestations of medullary thyroid carcinoma. The specific symptoms of medullary thyroid cancer include persistent watery diarrhea, not accompanied by severe malabsorption in the large intestine, often with facial flushing, some endocrine syndromes, and some associated conditions such as pheochromocytoma, multiple mucosal neuromas, and parathyroid adenomas.

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Late-stage symptoms of thyroid cancer

Differentiated thyroid cancer, in its advanced stages, can exhibit noticeable symptoms due to large nodules or invasion of surrounding organs. For example, a massive nodule pressing on the trachea can cause breathing difficulties, including respiratory distress. Compression of the esophagus can lead to swallowing difficulties, and pressure on the recurrent laryngeal nerve may result in symptoms like hoarseness. Even very few benign thyroid nodules can cause edema and inflammation by compressing these nerves. Therefore, differentiation and distinctive treatment are essential, along with a pathological diagnosis. Medullary thyroid cancer also presents specific symptoms, including persistent diarrhea, endocrine syndromes, and other accompanying conditions such as pheochromocytoma, multiple mucosal neuromas, and symptoms and signs caused by parathyroid adenomas.

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Thyroid cancer ultrasound manifestations

The characteristics of ultrasonography for thyroid cancer include the tumor being a solid hypoechoic mass with unclear boundaries, uneven internal echoes, abundant internal blood flow, and the presence of sandy calcifications and longitudinal growth, among others. Currently, ultrasonography is the preferred method for examining thyroid nodules. It can clearly identify the number, nature, and location of thyroid nodules, as well as whether there are any abnormally enlarged lymph nodes in the neck. Ultrasonography is highly accurate in differentiating the nature of thyroid nodules, with experienced ultrasonographers reaching an accuracy rate of over 80%. However, the highest accuracy in differentiating the nature of thyroid nodules is still achieved with fine-needle aspiration cytology.

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Is thyroid cancer without lymph node metastasis considered early stage?

Thyroid cancer, if it has not metastasized to lymph nodes, generally falls under early-stage. Once thyroid cancer is diagnosed, surgical removal is the primary treatment choice. Postoperative treatments vary depending on the different pathological types of thyroid cancer. For the most common type, papillary carcinoma, if the surgery is radically curative, further treatment may not be necessary, and merely supplementing thyroid hormones suffices. In cases such as follicular carcinoma, undifferentiated carcinoma, or medullary carcinoma, even after surgically radical removal, postoperative treatment often requires further radiotherapy or treatment with Iodine-131, depending on the surgical pathology results. (The use of medications should be carried out under the guidance of a professional doctor.)