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Thyroid Cancer Diagnosis

Accurate diagnosis can be very important to your treatment. At MD Anderson’s Endocrine Center, our experts are among the most experienced and skilled in recognizing and staging thyroid disease.
If you have symptoms that may signal thyroid cancer, your doctor will examine your neck and throat, feeling for lumps or swelling. Your doctor will also complete a medical history. This involves asking questions about your symptoms, other health problems and health problems in other members of your family. If anyone in your family has had thyroid cancer or parathyroid or adrenal tumors, be sure to tell your doctor.

One or more of the following tests may be used to find out if you have cancer and if it has spread. These tests also may be used to find out if treatment is working.

Fine-needle aspiration biopsy (FNA):  Biopsy (removal of a small number of cells and looking at them under a microscope) is the only way to tell for sure if you have thyroid cancer. In FNA, a thin needle is inserted into the nodule, and cells are taken out to biopsy. Most thyroid nodules are proved by FNA to be benign (not cancer). If the FNA is inconclusive (not showing clearly if the nodule is cancerous), more testing may be needed.

Imaging tests, which may include:

  • Ultrasound
  • CT or CAT (computed axial tomography) scans
  • MRI (magnetic resonance imaging) scans
  • PET (positron emission tomography) scans

Radioactive thyroid scan: If a nodule is papillary or follicular cancer, a radioactive thyroid scan may be used after thyroid surgery to determine if cancer remains or has spread to other parts of the body. Medullary thyroid cancer cells don't absorb iodine, so this test is not useful in this type of thyroid cancer.

Blood tests

Genetic testing: If you have medullary thyroid cancer, you will be given a blood test to determine if you carry a gene that sometimes causes this cancer. If the test is positive, your children and parents should be tested to see if they have the gene or thyroid cancer. More than 90% of people who have the gene will eventually develop thyroid cancer.

If your child has the gene, the doctor probably will suggest removal of the thyroid. Although children rarely develop cancer before 5 years old, one type of MTC known as MEN-2B can develop in the early months of life. If the thyroid is removed, then that person will take daily thyroid medication for the rest of his or her life.

If you have been diagnosed with thyroid cancer, we’re here to help. Call 1-877-632-6789 to make an appointment or request an appointment online.

Why Choose MD Anderson?

  • One of nation’s most active programs
  • Innovative thyroid cancer treatments, including minimally invasive and robotic thyroid surgery
  • Genetic testing and expertise in the care of hereditary thyroid disease
  • Accurate and precise diagnosis
  • Clinical trials of new therapies

Thyroid Cancer Knowledge Center

Treatment at MD Anderson

Thyroid cancer is treated in our:

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Thyroid Cancer Staging

If you are diagnosed with thyroid cancer, your doctor may do more tests to determine how big the tumor is and whether the cancer has spread to more places in the body. This process is called staging, and it helps your doctor plan your treatment. It also provides information about the expected outcome, or prognosis, of your cancer. Once the staging classification is determined, the stage stays the same even if treatment is successful or the cancer spreads.

Papillary and Follicular Thyroid Cancer Stages

People who are less than 45 years old have only Stage I or Stage II papillary or follicular thyroid cancer.

Stage I

Patient is less than 45 years old:

  • Tumor of any size
  • Cancer may have spread to other parts of the neck or nearby lymph nodes
  • Cancer has not spread to other parts of the body

Patient is 45 or older:

  • Tumor is 2 centimeters (about three-fourths of an inch) or less
  • Tumor is in the thyroid only
  • Cancer has not spread to other parts of the neck or body

Stage II

Patient is less than 45 years old:

  • Cancer has spread to distant areas, such as lungs or bone
  • Cancer may have spread to lymph nodes near these areas

Patient is 45 years or older

  • Tumor is between 2 and 4 centimeters (three-quarters to 1½ inches)
  • Tumor is in the thyroid only

Stage III

  • Patient is 45 years or older
  • Tumor is larger than 4 centimeters (1½ inches) or spread slightly outside thyroid
  • Tumor is of any size, but it has spread outside the thyroid and to lymph nodes in neck

Stage IVA

  • Patient is 45 years or older
  • Tumor is any size
  • Tumor has spread within the neck and to lymph nodes in the neck and upper chest

Stage IVB

  • Patient is 45 years or older
  • Tumor is any size
  • Cancer has spread to the neck near the backbone or around blood vessels in the neck or upper cheek
  • Cancer may have spread to lymph nodes

Stage IVC

  • Patient is 45 years or older
  • Cancer has spread to other parts of the body, such as the lungs or bone
  • Cancer may have spread to nearby lymph nodes

Medullary Thyroid Cancer Stages

Stage 0

  • No tumor has formed
  • Cancer is detected by screening tests

Stage 1

  • Tumor is 2 centimeters (three-quarters of an inch) or smaller
  • Tumor is in the thyroid only

Stage II

  • Tumor is between 2 centimeters and 4 centimeters (¾ to 1½ inches)
  • Tumor is in the thyroid only

Stage III

  • Tumor is larger than 4 centimeters (1½ inches)
  • Tumor is any size and has spread outside the thyroid to lymph nodes in the neck

Stage IVA

  • Tumor is any size
  • Tumor has spread within the neck and/or to lymph nodes in the neck or upper chest

Stage IVB

  • Tumor is any size
  • Tumor has spread to the neck, near the backbone or around blood vessels in the neck or upper chest
  • Cancer may have spread to lymph nodes

Stage IVC

  • Tumor has spread to other parts of the body, such as the lungs or bone
  • Cancer may have spread to nearby lymph nodes

Anaplastic thyroid cancer always is considered stage IV.

Recurrent thyroid cancer is cancer that returns after the original cancer has been treated. Although it usually comes back in the neck, thyroid cancer can appear in other parts of the body.

Getting a Second Opinion at MD Anderson

The pathologists at MD Anderson are highly specialized in diagnosing and staging every type of thyroid cancer, and we welcome the opportunity to provide second opinions.

If you would like to get a second opinion at MD Anderson, call 1-877-632-6789 to make an appointment or request an appointment online.


© 2014 The University of Texas MD Anderson Cancer Center