Obviously, there are going to be some recurrences, he noted, and there will be some small lymph nodes, so these patients do need to be followed, but they get taken out of an intensive follow-up program and put on once-a-year program.
Explore This IssueDecember 2006
This is a nice paradigm to use, he said. It allows us to identify patients that are probably cured of their disease.
Diagnosis Tips from the Experts
Why is fine-needle aspiration so uncertain? Because a great number of cells are needed to be able to look at the morphology of the nucleus as well as the cytoplasm.
In about 20 percent of cases, there is simply not enough material, and another 20 to 30 percent where the material is of an indeterminate nature, he said. This means in at least 40 percent of cases, you’re going to have unanswered questions. The big problem is that nobody wants to come back to a patient five years later and tell them that nodule was really of significance and you missed it. – Shereen Ezzat, MD
On the shift away from radioactive iodine:
It’s not that I’m getting rid of nuclear medicine, and it’s not that I’d never do radioactive iodine scans, but they are no longer the primary tools that we use. Our primary tool really revolves around the thyroglobulin blood test and now, most importantly, neck ultrasound. – R. Michael Tuttle, MD
Why do ultrasound?
We know that ultrasound is not the most elegant imaging technique; people like PET and CT. But ultrasound of the cervical nodes makes a major contribution to the presurgical planning of thyroid cancer by detecting early ipsilateral and contralateral clinically occult cervical node metastasis that otherwise would not have been included in the surgical dissection. – Beth Edeiken, MD
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©2006 The Triological Society