Tirads 5 and pregnant

Hi Becosh84 and a very warm welcome to the online community which I hope you'll find is both an informative and supportive place to be.

First of all, congratulations on your pregnancy but I'm sorry that you have these worries during a time when you should just be concentrating on the upcoming birth.

I'm going to 'tag' my friend barbaral as she's very knowledgeable about most things to do with the thyroid and hopefully she'll be able to pop on and answer your questions based on her experiences.

While you're waiting for replies, it would be great if you could pop something about your diagnosis and any treatment you've had into your profile as it really helps others when replying to you and also when looking for someone on a similar pathway. It also means that you don't have to keep repeating yourself. To do this click on your username and then select 'Profile'. You can amend it at any time and if you're not sure what to write you can take a look at mine by clicking on my username.

Are you in the USA? 

We don't use TIRADS in the UK (where Macmillan is based) so this isn't something I know much about but I believe it's a ranking system for ultrasounds.

You can't diagnose thyroid cancer conclusively from an ultrasound. I believe TIRADS is used to determine whether it's necessary to do a Fine Needle Aspiration - and TIRADS 5 would qualify for that.

Once you reach FNA, it's still not guaranteed that you'll know if something is cancer because the second most common form of thyroid cancer generally can't be confirmed by FNA.

So, what this means is that you're still a step or two away from any confirmed diagnosis.

I have known people get diagnosed during pregnancy. One example I recall was somebody who has to wait for the third trimester before the surgeons were willing to operate. I guess they needed the baby to be a bit more advanced before they gave it a go.

More typically, they would probably discuss your wishes, and potentially wait for you to have your baby and give you a few months and THEN operate. Or if the lump was small enough, they might give you longer or do a watch and wait.

A lot more would need to be known than a TIRADS score before any decision would be made.

Most thyroid cancers are very slow growing. Unless they have reason to think it's urgent to get in there, I'm sure you can discuss waiting a while until you're ready.

Yes, I'm in the US. I apologize that I didn't know the tirads was only in the US! I'll definitely talk to my doctor about the FNA. But if that can't diagnose all forms of thyroid cancer, what other steps need to be done if the FNA is negative?

No apology needed. We don't mind where people live - everybody is welcome. BUT it's really useful for us to know that you're not in the UK because we all tend to talk about the local protocols in the UK and if we don't know you're not here, sometimes that won't apply in your country.

It's testament to how wonderful this group is that our influence stretches far and wide and people thousands of miles away find us through Google searches.

If the FNA is NEGATIVE - you don't have cancer. It really is that simple.

What's not so simple is when the FNA is INCONCLUSIVE or SUSPICIOUS. That's where a diagnostic hemithyroidectomy kicks in.

There may be more sophisticated and expensive alternatives in the USA but over here, it's 'if in doubt' whip half out'