I am a 31-year-old woman who underwent papillary thyroid cancer surgery last year. In the recent ultrasound examination, a lymph node was reported in my neck, do I have to do surgery or are there other ways?

Answer by Dr. Ali Bakhshi, thyroid surgeon 

If your previous surgery was only limited to the thyroid, it is better to remove the lymph nodes surgically. We use alcohol injection into lymph nodes or RF method.

Palpation of a mass in the patient’s right breast. A 28-year-old woman with a history of observing a mass in her breast and surgery to completely remove the mass (according to the patient herself), has returned to the doctor due to a palpation of a mass in her right breast. The patient has normal vital signs, does not present pain, discharge, discoloration, or history of any special problem.

How dangerous is this mass and should it be operated on?

What should he do to recover?
Does this mass affect the condition of the patient for pregnancy or not?
Do you need to take special medicine or not?

At this stage, the specialist doctor and the best breast cancer surgeon responds to the patient’s concerns in this way:

We study the patient’s records: the fibroadenoma was removed due to the patient’s request and concerns, the last mammogram was 2 months ago and there are no problems, and the blood test is normal. There is no sign of pain, itching, restriction of movement and discharge in the breasts. He has no history of disease except previous fibroadenoma. He does not take any medicine, he has no history of any special disease, during the examination, a small lump with a certain consistency can be felt in the right breast, there is no pain, there is no discharge, there is no change in color, the mass is slightly mobile, according to the stress of the patient and to control more We also request mammography and ultrasound.

1- There is no possibility of special risk, but we check the size and extent of the mass with mammography, if there is no special problem, follow-up once every 6 months is enough and there is no need for surgery.

2- If the patient does not have discomfort related to the tumor (for example, pain), there is no need to take any special medicine and there will be no problem for the patient, but if the tumor gets bigger later and the patient experiences stress and anxiety, surgery can also be considered.

3- This lump has nothing to do with pregnancy and does not cause any problems for pregnancy.

What are adrenal diseases?

Dr. Ali Bakshi’s answer is the best endocrine surgeon

The adrenal gland is located above the kidneys and its function is to secrete important hormones such as cortisol, adrenaline and aldosterone. Sometimes the adrenal gland becomes overworked or undergoes an increasing tumoral growth, which results in an increase in the secretion of the mentioned hormones. Of course, sometimes adrenal tumors do not have any secretions and only show themselves due to excessive enlargement.

What is Cushing’s disease?

Cushing’s disease (adrenal hyperplasia that leads to increased secretion of cortisol), pheochromocytoma (adrenal hyperplasia that leads to increased secretion of catecholamines and metanephrine) can be mentioned as important diseases of the adrenal gland. In case of any of the adrenal diseases, the main treatment is to remove the patient’s gland by surgery. Today, most adrenal surgeries can be performed laparoscopically, except in cases of large and advanced tumors

patient question

How to find out if stomach cancer is advanced or not?

Dr. Ali Bakshi’s answer

After the diagnosis of stomach cancer, the first step is to perform CT SCAN. CT SCAN, which we do orally and intravenously from the chest, abdomen and pelvis. The disease in advanced cases is identified by doing this.

patient question

A 50-year-old woman was referred due to palpation of a lump in the neck. In ultrasound, a hypoecho nodule with a diameter of 2 cm was observed in the left thyroid lobe. Follicular lesion of undetermined significance is reported in the cytopathological examination, FNA is repeated after 2.5 months and the same result (FLUS) is obtained. In the laboratory examination, the serum TSH level is low normal, what action is recommended for the patient?

Dr. Ali Bakshi’s answer

If the result of the cytopathological examination of thyroid nodule, follicular neoplasm or FLUS and the TSH level is low normal, a thyroid scan is requested by the best thyroid surgeon. If the nodule is functional in the scan, it is benign and will be followed up with ultrasound (12-24 months later). In cases where the nodule is non-functional in the scan, surgery or molecular testing is the next step.

patient question

Age to start breast exam for breast cancer control

Dr. Ali Bakshi’s answer

This is possible at any age and time, but usually after the age of forty, the possibility of contracting this disease is more among women. For this reason, women should note that they can examine themselves whenever they want. If there are no facilities and women are busy and do not have time, the easiest way is to examine themselves at least once a month to find out if their breasts have changed or not. There are different ways to examine the breast, but the best and easiest is to lie down and put your right or left hand under your head and slowly touch your breast with the other palm. Then, with three thumbs, index and middle fingers, first press their breast a little and touch it slowly.

If they do not feel a change or lump, increase the pressure so that they have touched the depth of the breast besides the skin. If they notice a change, they should consult with their top breast cancer surgeon. Sometimes women can stand in front of the mirror and touch their breasts with their palms and fingers as mentioned. It is very important to consult a doctor at the very first stage, because in case of breast cancer, the gland or cancerous part can be removed easily with a simple surgery, and the progress of the disease is prevented, and the cancer will no longer metastasize and spread. will not find

patient question

How can a nuclear scan be performed after iodine therapy for thyroid cancer?

Dr. Ali Bakshi’s answer

After iodine therapy, a thyroid nuclear scan is performed to check the patient’s condition, obviously due to the high sensitivity of scanning the points operated by the best thyroid cancer surgeon and possibly thyroid cells or microscopic remnants of the thyroid and lymph nodes remaining in the dye scan. Takes. In many cases, the report of the scan causes distress and worry to the patients about remaining thyroid or lymph nodes and possibly re-surgery. It should be noted that many of these reports are actually only worth investigating the current situation and cannot be accurate about the possibility of re-surgery.

The important point is that thyroid surgeons may recheck the patient’s condition with ultrasound after the operation (2 to 3 months after iodine therapy) and it is necessary to remind our dear patients not to worry about the findings of the scan. Wait for the accurate ultrasound answer after 2 to 3 months.