PET Scan and thyroid question

[1rarebird]

I received good news yesterday regarding the results of my PET/CT scan which I had done last week. I am grateful and encouraged that no suspicious chest wall, axillary, or intrathoratic findings were indicated; as well the non-avid apical nodule in my left lung appears to have not changed in size or nature in the last 15 months.

However, I am in a quandary as what to do regarding my thyroid that continues to show significant glucose avid nodular activity, just as it did at my first PET/CT 15 months earlier. Then as now, the radiologist recommends a fine needle aspiration (FNA) biopsy of my thyroid to determine what is causing the abnormal scan there. Last year I followed that recommendation and had a surgeon conduct the FNA biopsy. He took three samples. (It was quite painful, even for my usually high level of pain tolerance.)

The results from the FNA procedure were inconclusive, with a finding of Hurthle cell lesions which were explained to me could be either cancerous or not. A more extensive excisonal biopsy would be necessary to determine which one is the case. But because of my chemo, radiation and Hecepton treatments that were pending, the surgeon said that I could wait a year before having that more extensive biopsy. He said the risk was low in waiting the year, since even if the lesions were cancerous, thyroid cancer is almost always slow in developing and fortunately rarely spreads to other parts of the body.

So this most recent PET/CT scan was done and the glucose avid thyroid nodules are still there. But this scan showed the appearance of the lesions "unchanged" from last year.

I have been as aggressive as allowed in treating my early stage breast cancer for the last 15 months. And I will continue with that approach, as long as it makes since. But I wonder if this excisonal biopsy is really necessary. (I even had my endocrinologist advise me a few months ago "just have the thyroid removed, since you are worrying kind." But that sounded extreme to me.)

So I am wondering what experience others on this board have encountered relative to thyroid nodules, PET scans and the connection, if any, between their breast cancer and thyroid disease. What else could make a thyroid 'light up' in a PET? I need to make up my mind soon about seeing that surgeon again.

bird