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How is thyroid cancer diagnosed?

If a person has symptoms that suggest thyroid cancer, the doctor may perform a physical exam and ask about the patient’s personal and family medical history. The doctor also may order laboratory tests and imaging tests to produce pictures of the thyroid and other areas.

The exams and tests may include the following:
– Larger and more anteriorly (front) located nodules can be felt by the examiner.
– A physician will ask about any other medical history and any risk factors for thyroid nodules or cancer, including family history of thyroid cancer or radiation exposure of the head or neck.
– Thyroid stimulating hormone (TSH) levels and levels of thyroid hormone can indicate whether the thyroid is under- or overproducing thyroid hormones.
– Anti-thyroid antibody levels can indicate the presence of autoimmune thyroid inflammation that can be seen with Hashimoto’s thyroiditis.
– Calcitonin levels in the blood can indicate a specific type of thyroid cancer, known as medullary carcinoma of the thyroid.
– Ultrasound : This is a test that uses sound waves to take a picture of the thyroid. An ultrasound can reveal which thyroid nodules are larger than 1-1.5 centimeters, requiring further evaluation for cancer. It includes number of nodules, location of nodules, distinctness of borders, fluid versus solid contents, other nodule contents, such as calcium deposits, or the amount of blood flow.
– Radionuclide scanning : The doctor may order a nuclear medicine scan that uses a very small amount of radioactive material to make thyroid nodules show up on a picture.
– Biopsy : The removal of tissue to look for cancer cells is called a biopsy. A biopsy can show cancer, tissue changes that may lead to cancer, and other conditions. A biopsy is the only sure way to know whether a nodule is cancerous.

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