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Surveillance, Epidemiology, and End Results Program show that thyroid cancer diagnoses have skyrocketed since 1975, while deaths associated with the disease have remained flat. In the last decade, the rate of new thyroid cancer cases has risen, on average, nearly 6.5 percent annually. "When sticking a biopsy needle in every nodule found on an imaging scan, of course you will find more cancer," Dr. Datta says. "The majority of biopsies result in papillary thyroid cancer diagno- ses. There is no reason to overtreat this kind of cancer. For example, there is no reason to biopsy a 2-mm growth that may very well be cancer. The physician should simply follow it. These are indolent cancers, and their history shows they may never grow. If you were to take sonograms of 10 people on the street, it's likely that three or four will have thyroid nodules." P h y s i c i a n s i n S o u t h N a s s a u Communities Hospital's Thyroid Center practice a deliberate process to differenti- ate malignant and benign nodules and identify the best course of treatment. Importance of Process Patients may initially enter the care of any provider in the Thyroid Center, but no matter who performs the initial evaluation, it includes taking a thorough history to illuminate inherited risks of thyroid cancer or prior radiation delivered to the head and neck for benign condi- tions, such as acne or adenoidal, thymus or tonsillar enlargement. Thyroid cancer disproportionately affects females and commonly presents in people between the ages of 45 and 50. The disease is more aggressive in older patients, according to Dr. Lomasky. After taking the patient history and performing the physical exam, physicians synthesize the information and determine whether or not the underlying pathology suggests malignancy. If preliminary workups don't quell suspicions, additional imaging details the thyroid's anatomy. "The best imaging at this point is thyroid ultrasound," Dr. Lomasky says. "Certain sonographic characteristics are associated with a higher likelihood of "In the 27 years I've been on staff at South Nassau Communities Hospital, our thyroid program has grown to locally provide the full spectrum of services expected from tertiary care centers. We're an excellent source of care in the community." — Steven Lomasky, MD, Chief of Endocrinology and Diabetes, Chair of the Endocrine and Diabetes Management Committee at South Nassau Communities Hospital Abraham Port, MD, Medical Director of Breast Imaging at South Nassau and Medical Director of Breast Imaging at Complete Women's Imaging, performs a fine-needle aspiration biopsy of the thyroid. Steven Lomasky, MD, Chief of Endocrine and Diabetes and Chair of the Endocrine Disease Management Committee at South Nassau Communities Hospital, performs a thyroid screening on a patient. M D N E W S . CO M ■ MD NEWS Long Island | 7