Abstract

The diagnosis of papillary thyroid cancer (PTC) is usually made through a fine needle aspiration (FNA) biopsy. The evaluation of a patient with biopsy-proven PTC requires a thorough history and physical examination and appropriate laboratory tests and imaging studies. What can be determined about the cancer in the preoperative setting is discussed with the patient and the optimal treatment is chosen. Some patients with small-volume, low-risk cancers are being actively observed as part of research protocols. The vast majority of patients, however, are treated surgically, and the key decision points are the extent of surgery and the management of lymph nodes. A rational approach to the workup of thyroid nodules and the management of thyroid cancer is needed to curb the growing epidemic of overdiagnosis.

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