Oct 13, 2022 03:55PM emmaleah wrote:

Hi maggie, thanks, and all the best on all the issues you are managing and balancing. I agree that there is not much definitive research, and that we each need to make decisions about endocrine therapy as best we can in our individual situations and often without the benefit of much in the way of a prediction as to how we will do on it. I am glad to hear that your MO is supportive and that the absolute added risks are small, especially if counterbalanced against other important risks.

That 2021 paper on thyroid and estrogen has taken me aback by identifying exogenous thyroid hormone as a risk factor and an independent driver of ER+ breast cancer, almost as if it (thyroid hormone) were estrogen itself, which of course we are precisely trying to limit the effects of, when we do endocrine therapy.

Personally I need to take thyroid hormone (post-thyroidectomy for thyroid cancer), but I do want to monitor and keep the thyroid dose and TSH normal rather than high dose with low TSH (even though often recommended post thyca). I have sent my MO the paper and will ask next month when I see her about the various endocrine therapy options. I also submitted a question to the UCSF Bay Area Breast Cancer Forum to see if they (breast oncology team with a periodic public-facing online panel discussion) might have thoughts.

A lot of middle aged and older women are in both camps -- we take thyroid hormone and have had ER+ breast cancer. Hopefully some better guidance about endocrine therapy in the context of taking thyroid hormone can emerge from some of this.

Oct 21, 2022 09:23PM maggie15 wrote:

It’s good that both the BMX and thyroid biopsy are over. I love your crime scene analogy. If you end up needing surgery you will look like your throat has been slashed for a while. I could have worn scarves to hide the gash but didn’t bother. Thanks to Embrace silicone scar therapy my scar is nearly invisible now. I hope you get good news in a week

Oct 25, 2022 02:30PM maggiehopley wrote:

It's good news- benign follicular nodule. I might still have to have it removed if it grows larger, but at least I'm okay for now. Thank you all for your support!

Nov 11, 2022 07:28PM momof2winsplus wrote:

I had lobular breast cancer almost 3 years ago. Had DMX and radiation, where my esophagus was burned, then tamoxifen and letrozole.

Had ultrasound today for a suspicious thyroid nodule.

Report: There is a suspicious nodule at the upper pole of the right thyroid lobe measuring 9 mm along with multiple suspicious left-sided cervical lymph nodes ranging up to 14 mm. These contain punctate echogenic foci and are concerning for metastatic disease. Recommend fine-needle aspiration of the largest left cervical lymph node.

It is so frustrating to be starting this all over again. Need to have biopsy and meeting with surgeon next week. Being back on this board makes it a little easier.

Nov 28, 2022 06:28PM emmaleah wrote:

Hi momof2winsplus, sending you strength and hugs and support. So sorry that you have to deal with workup for suspicious thyroid nodules and neck lymph nodes. All the best on fine needle aspiration (FNA) node biopsy. In my experience, both my FNA biopsies (of thyroid nodule and neck node) felt quite weird, but they were much less painful than my breast biopsy. (I compared the two experiences, thyroid vs. breast biopsy, in a previous post above.)

I also want to reassure you overall that if it does end up being thyroid cancer lymph node metastases, that thyroid cancer is overwhelmingly quite curable, and that node mets are very common in thyca (>50% of us) and are much less detrimental or escalatory to treatment than node mets when they occur with breast cancer, for example.

Personally, I had thyroidectomy and lymph node removal for thyroid cancer nine-plus years ago at 43, and have been happily free of (that) disease after the one surgery plus one dose of radioactive iodine at that time. It took me a little while (some months) to get dialed in on the thyroid replacement meds, but things have been going fine thyroidwise since then.

One thing to consider requesting be done at the time of FNA node biopsy is a test called "FNA Washout Thyroglobulin (Tg)" which measures the amount of a thyroid-specific protein that is found in a saline wash of the biopsy needle. That test is very specific and very sensitive for thyroid cancer when done in a lymph node, but I'm not sure that it is routinely done.

All the best on next steps, and keep us posted.