# Positive for Malignancy



## Aprilw357 (Sep 4, 2017)

Wanted to update those I've spoken to on here with the results of my biopsy I had done on the 20th... Unfortunately they show Papillary Thyroid Carcinoma. So now I'll be waiting until they can Biopsy an enlarged lymph node on the same side. If it is not in the lymph not (not metastatic) then we go from there on scheduling the thyroidectomy.

For those of you that have had this...

Were you given a stage? My report doesn't show one.


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## joplin1975 (Jul 21, 2011)

Staging for thyroid cancer usually takes place with the post-op pathology report.

I don't know what level your enlarged nodule is in, but most surgeons do a prophylactic neck dissection during the TT surgery. That means that they take the five most proximate lymph nodes on either side of the thyroid (10 total). It's sort of an "get it cleaned out while we are in there" policy. They might go to the next level if things look suspicious.

My point being that I don't see a need for a second biopsy. Take the nodes out regardless.


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## Aprilw357 (Sep 4, 2017)

That's interesting. From what I've been told my surgeon has done a lot of thyroid removals so I wonder why she didn't tell me that? Should I be concerned if she didn't know that? She's the only person managing this (a general surgeon), did you see an oncologist with yours Joplin?


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## joplin1975 (Jul 21, 2011)

I didnot see an oncologist. Very few thyroid cancer patients use an oncologist, although it does happen.

My surgeon was a general surgeon, technically, but he's made a career of treating thyroid and breast cancer (the two tended to be related). He rarely does other surgeries. That's the key - you want a thyroid specialist, whether they are a general surgeon, an ENT, a head/neck surgeon, or an surgical endocrinologist. It does not matter. What matters is that they are a "high volume" surgeon (do a search for "high volume" on these boards and you should find an article I posted a few years ago that shows success is directed linked to surgical experience). You don't want someone who does three or four per year. They should be doing 100s.

Ask her what information she would get from the biopsy and tell her you are interested in a neck dissection too. If she pushes back, she should have a really, really good reason...

Edit to add: http://thyroidboards.com/forums/topic/17954-for-best-outcomes-pick-a-high-volume-surgeon/?hl=%2Bhigh+%2Bvolume


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## Aprilw357 (Sep 4, 2017)

Okay I'm going to look into all of that. Thank you so much Joplin. I can't tell you what it means to me or how much it helps ease my mind to have someone to ask these questions that has been through this. I truly appreciate it.


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## joplin1975 (Jul 21, 2011)

You are very welcome -- please let me know if I can be helpful in any other way.

By the way, while I did not have a node biopsy before surgery, I DID have what is known as a lymph node mapping ultrasound. Basically, instead of looking at the thyroid, which we knew we were getting rid of, we took a close look at the surrounding lymph nodes to "flag" any that looked suspicious.

This summary article might be of interest: http://online.liebertpub.com/doi/abs/10.1089/ct.2017%3B29.16-18?journalCode=ct


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## Aprilw357 (Sep 4, 2017)

Very interesting. Im going to discuss this all with my surgeon at the next appt. thank you again, so much.


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