Current Guidelines for the Management of Thyroid Nodules

Robert A. Levine, MD, FACE, ECNU


Endocr Pract. 2012;18(4):596-599. 

In This Article

Why Does Size of a Nodule Have a Central Role in Guidelines?

All available guidelines use size criteria to select thyroid nodules for biopsy. Numerous studies have shown poor or no correlation between size of thyroid nodules and risk of malignancy. The risk of metastatic involvement (and therefore mortality), however, does have an association with nodule size. The ATA guidelines state that most small malignant lesions are associated with a favorable outcome. They acknowledge that there are rare situations in which subcentimeter microcarcinomas will have locoregional or distant metastatic lesions. They state, however, that, …attempts to diagnose and treat all small thyroid cancers in an effort to prevent these rare outcomes would likely cause more harm than good.