Current Guidelines on Benign Thyroid Nodules Challenged

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Research suggests they don't need to be monitored as closely as current guidelines recommend.
Research suggests they don't need to be monitored as closely as current guidelines recommend.

Benign thyroid nodules are common, and research suggests they don't need to be monitored as closely as current guidelines recommend. The findings were published in the Journal of the American Medical Association.

The new study challenges the need for close monitoring in many cases. Italian researchers followed 992 patients with presumably benign thyroid nodules.

All patients had either had a biopsy, or had skipped the biopsy because an ultrasound showed their nodules to be tiny and free of suspicious features that could signal cancer.

Over five years of monitoring with yearly ultrasound scans, most patients' thyroid nodules showed no substantial change. For 15 percent, the nodule grew by 50 percent in volume, while it shrank for 19 percent.

Most importantly, only five nodules -- or 0.3 percent -- were eventually diagnosed as thyroid cancer, the investigators found.

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Anne Cappola, M.D., of the University of Pennsylvania Perelman School of Medicine in Philadelphia, who wrote an editorial published with the study, called the findings good news.

"Patients diagnosed with benign nodules should all feel reassured that during the follow-up period, the likelihood of finding cancer is very low," Cappola told HealthDay. But, she added, the results also suggest that the current approach of monitoring patients is "not the most efficient way" to catch the small number who really have thyroid cancer. "We've probably been too aggressive with follow-up," she said.

Reference

  1. Durante, Cosimo, MD, PhD, et al. "The Natural History of Benign Thyroid Nodules." JAMA. doi:10.1001/jama.2015.0956. March 3, 2015.

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