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Renowned Surgeons Publish Thyroid Nodule Size Chart During Thyroid Disease Awareness Month

Clayman Thyroid Center logo (PRNewsfoto/Clayman Thyroid Center)

News provided by

Clayman Thyroid Center

Jan 12, 2023, 11:26 ET

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TAMPA, Fla., Jan. 12, 2023 /PRNewswire/ -- January is Thyroid Disease Awareness Month, celebrated this year by the thyroid surgeons at the Hospital for Endocrine Surgery by publishing a new thyroid nodule size chart that lay-people can use to determine the significance of any thyroid nodule. Thyroid disorders are quite common including thyroid cancers, thyroid goiters, or autoimmune diseases like Hashimoto's or Grave's Disease. But by far the most common thyroid abnormalities are thyroid nodules.

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Thyroid nodules are the number one reason for thyroid surgery world-wide, with the need for surgery increasing as the nodule becomes bigger.

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Thyroid nodule size chart showing likelihood for surgery based on thyroid nodule size.
Thyroid nodule size chart showing likelihood for surgery based on thyroid nodule size.
Thyroid nodule size chart demonstrates relative size and the effects large nodules have on the thyroid gland. Enlarged left thyroid lobe shown would lead to symptoms like difficulty breathing and swallowing and would require surgical treatment.
Thyroid nodule size chart demonstrates relative size and the effects large nodules have on the thyroid gland. Enlarged left thyroid lobe shown would lead to symptoms like difficulty breathing and swallowing and would require surgical treatment.

A thyroid nodule is a growth on or inside the thyroid. Thyroid nodules are so common that most of us will have at least one in our lifetime. The incidence of having a thyroid nodule increases with age, with most adults over 50 having at least one thyroid nodule. Thus, knowing the significance of a thyroid nodule is very important. Thyroid nodules are the number one reason for thyroid surgery world-wide, with the need for surgery increasing as the nodule becomes bigger.

"We have known for many years about the correlation between thyroid nodule size and the need for thyroid surgery, but until now there has been no published graphic illustrating this relationship," says Dr. Nate Walsh, senior surgeon of the Clayman Thyroid Center at the Hospital for Endocrine Surgery. "Although the vast majority of thyroid nodules are not cancerous, that does not mean they do not require treatment or can be ignored."

To produce the thyroid nodule size chart, thyroid surgeons reviewed data from the Center's past 10,000 thyroid surgeries to show the percent chance of needing surgery to remove all or part of the thyroid according to the size of the nodule. The presence or absence of other issues such as cancer or hormone production was ignored and only the size of the nodule was considered significant. The relationship between thyroid nodule size and need for surgery became very nicely illustrated when thousands of nodules were graphed together.

In evaluating the size of thyroid nodules requiring surgery, Dr Walsh noted 4 important things to know about thyroid nodules, publishing an article of his findings online. The most important finding was that size is very important and by itself can indicate the chance of needing surgery.  

"It's always one of the most common questions we hear after a patient has a thyroid ultrasound," noted Dr Walsh. "They immediately want to know what their chances of needing surgery are. But it is very hard to conceptualize the size of your thyroid nodule when it's given to you in centimeters with no reference point. It's especially tough to think about the nodule size in relation to the size of your thyroid gland since nobody knows the size of a normal thyroid in centimeters to begin with."

To address this issue, Dr Walsh included several common food items that everyone is familiar with and readily knows the size of. "Think about it—what's easier to understand: hearing that your thyroid nodule is 4 cm in diameter, or hearing that your nodule is the size of a lemon."

The fact is, 4 cm is indeed the cutoff agreed upon by the thyroid surgeons of the Clayman Thyroid Center and confirmed by numerous published medical journal articles. Nodules larger than 4 cm are typically best treated in most people by removing that portion of the thyroid lobe.  As nodules get larger over time, which they commonly do, the symptoms they cause worsen. Difficulty breathing and swallowing will start to affect the patient's quality of life and a noticeable lump in the neck may become visible.

Thyroid cancer is another big concern for patients with thyroid nodules. However, aside from the symptoms associated with a large thyroid nodule, bigger is not always worse. Thyroid nodule size does not correlate directly with the nodule being cancerous or benign. Often thyroid nodules are biopsied to test for the presence of cancer; however, the surgeons note that biopsies done on them are only as good as the teams performing and interpreting them.

"It is so important to seek thyroid nodule evaluation at a high-volume specialty center," said Dr. Gary Clayman, founder of the Clayman Thyroid Center. "I hear a lot of patients say 'I had a biopsy done and it was fine.' Thyroid needle biopsies are great tests, but they do not tell the whole story. As many as 50% of thyroid cancers are not diagnosed until after the nodule has been removed through surgery. That should be uncommon, and when it occurs it typically shows a poor preoperative evaluation."

"We do nothing but thyroid surgery, all day, every day. We have seen it all and know what looks suspicious," said Dr. Rashmi Roy, senior surgeon at the Clayman Thyroid Center. "Our ultrasound techs are the most experienced in the world and they can assess so much more than just nodule size, like whether a nodule is solid or filled with fluid (solid is more likely to be cancerous). They can even see what the blood supply to these nodules looks like and determine if the cancer has potentially spread to the lymph nodes in the neck."

Further illustrating this point, a free thyroid ultrasound screening program was held last year at a women's wellness retreat in Tampa, performed by the expert ultrasound techs of the Hospital for Endocrine Surgery. Of the women screened, 49% were found to have a thyroid nodule that they didn't know existed and that required further evaluation, with 10% requiring surgery for potential thyroid cancer.

The Clayman Thyroid Center is the nation's highest volume thyroid surgery center, performing approximately 2,000 thyroid operations per year. Its surgeons perform thyroid surgery exclusively and operate at the Hospital for Endocrine Surgery in Tampa, Florida, which just celebrated its one-year anniversary. Prior to moving into their new home at the Hospital for Endocrine Surgery, Drs Clayman, Roy, Suh and Walsh were the heads of endocrine surgery departments at renowned institutions like MD Anderson, Princeton and Mt. Sinai.

Read Dr. Walsh's full article on thyroid nodules: Top 4 Things to Know About Thyroid Nodule Size

Check out Dr. Roy's Thyroid Surgery YouTube channel where she details her most interesting thyroid cases, demonstrates how to check yourself for thyroid cancer and more.

The Clayman Thyroid Center operates alongside its sister surgeons at the Hospital for Endocrine Surgery, including those of the Norman Parathyroid Center and the Carling Adrenal Center. Together, they are the world's highest volume endocrine surgery practice and are solely dedicated to the surgical treatment of thyroid, parathyroid and adrenal tumors and cancers.

About the Clayman Thyroid Center:

Founded by one of the nation's best-known thyroid surgeons, the Clayman Thyroid Center is the highest volume thyroid cancer referral center in the United States. The Center boasts the most experienced thyroid surgeons in the US who provide personalized care allowing the greatest opportunity for cancer cure, wellness and cosmetic, and functional, outcomes via all types of thyroid surgery from minimal incision to scarless thyroid surgery to advanced cancer care.

www.thyroidcancer.com | (813) 940-3130

About the Norman Parathyroid Center

Located in Tampa, Florida, the Norman Parathyroid Center is the leading parathyroid gland tumor treatment center in the world, performing nearly 3,800 parathyroid operations annually. Well known for cure rates over 99% via an operation that typically lasts about 20 minutes, the Norman Parathyroid Center's success centers on a teamwork approach by the most experienced parathyroid surgeons in the world.

www.parathyroid.com | (813) 972-0000

About the Carling Adrenal Center:

Founded by Dr. Tobias Carling, one of the world's leading experts in adrenal gland surgery, the Carling Adrenal Center is a worldwide destination for the surgical treatment of adrenal tumors. Dr. Carling spent nearly 20 years at Yale University, including 7 as the Chief of Endocrine Surgery before leaving in 2020 to open to Carling Adrenal Center, which performs more adrenal operations than any other hospital in the world.

www.adrenal.com | (813) 972-0000

About the Hospital for Endocrine Surgery

The Hospital for Endocrine Surgery is a campus of HCA Florida South Tampa Hospital focused on compassionate patient care and highly specialized treatment of endocrine tumors. We provide a wide array of services necessary for the diagnosis and surgical treatment of tumors of the thyroid, parathyroid and adrenal glands. Our team includes doctors, surgeons, nurses and technicians who have dedicated their careers to delivering the highest cure rates using the most advanced techniques available. HCA's Hospital for Endocrine Surgery is the nation's highest volume hospital for thyroid, parathyroid, and adrenal tumors and cancers.

www.hospitalforendocrinesurgery.com

Contact:
Julie Canan
+19414683002
[email protected]

SOURCE Clayman Thyroid Center

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