Most Benign Thyroid Nodules Remain Benign

Sebastiano Filetti MD Dipartimento di Medicina Interna Università di Roma Interview with;
Sebastiano Filetti MD

Dipartimento di Medicina Interna
Università di Roma Roma

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Filetti: Thyroid nodule diagnosis is becoming more and more frequent in clinical practice. This trend stems largely from the incidental discovery of small nodules due to the increased use of diagnostic imaging for purposes unrelated to the thyroid. Ultrasound studies, for example, are widely used for evaluating other structures in the neck, such as the carotid arteries, parathyroid glands, lymph nodes, and salivary glands. Over 90% of detected thyroid nodules are clinically insignificant, in that they have been cytologically proven to be benign or they have no ultrasound features that raise the suspicion of malignancy. However, consensus is lacking regarding the best way to follow these nodules, mainly because little is known about the actual frequency and magnitude of their growth. The results of our study suggest that most benign nodules exhibit no significant size changes over time, and some actually decrease in size. Only a small subgroup of nodules can be expected to grow, about 15% in our series. However, the growth is slow and limited in magnitude. Most important, the occurrence of cancer is very rare in nodules like this, that appear to be benign.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Filetti: The discovery of a thyroid nodule is naturally a source of concern for the patients, and clinicians appreciate this concern. However, for patients with either cytologically benign or sonographically nonsuspicious thyroid nodules, our findings are very reassuring. After the initial assessment, they can be safely managed with a second ultrasound examination 1 year after the first, and if that exam shows no changes, the next test can be scheduled in 5 years.

MedicalResearch: What recommendations do you have for future research as a results of this study?

Dr. Filetti: Based on our data, the highest risk of growth was observed in younger patients or older, overweight individuals with multiple, large nodules. But, even when growth does occur, this does not mean that the nodule is more likely to become malignant. Therefore, we need to identify other factors that will predict which nodule will become cancerous.


Durante C, Costante G, Lucisano G, et al. The Natural History of Benign Thyroid Nodules.
JAMA. 2015;313(9):926-935. doi:10.1001/jama.2015.0956
. Interview with; Sebastiano Filetti MD (2015). Most Benign Thyroid Nodules Remain Benign 

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Last Updated on March 5, 2015 by Marie Benz MD FAAD