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Thyroid Cancer

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Staging

Thyroid cancer is divided into stages that describe the tumor's size and how far the tumor has spread through the body. Generally, higher stages denote more spread of the cancer. A healthcare practitioner will determine the cancer's stage primarily through biopsy and imaging tests. Staging is important for determining treatment and prognosis. For more detail, see the section on "Biopsies and examination of tissues" in the Anatomic Pathology feature article.

For thyroid cancer, different staging criteria are used depending on a person's age and the type of thyroid cancer they have.

For papillary and follicular thyroid cancer in people younger than 45:

Stage I: The tumor is any size; cancer may be in the thyroid, or may have spread to nearby tissues and lymph nodes. It has not spread to other parts of the body.

Stage II: The tumor is any size; cancer has spread from the thyroid to other parts of the body and may have spread to the lymph nodes.

For papillary and follicular thyroid cancer in people older than 45:

Stage I: The tumor is 2 centimeters or smaller; cancer is limited to the thyroid.

Stage II: The tumor is 2-4 centimeters; cancer is limited to the thyroid.

Stage III: The tumor is larger than 4 centimeters and cancer is limited to the thyroid, or the tumor is any size and cancer has spread to just outside the thyroid or has spread to lymph nodes near the trachea or larynx.

Stage IV: The tumor is any size; cancer has spread outside of the thyroid to neck tissues and possibly the lymph nodes, or has spread to distant parts of the body such as lungs and bones.

Medullary thyroid cancer for any age:

Stage 0: Cancer is only detected with screening; no tumor is found in the thyroid.

Stage I: Tumor is 2 centimeters or smaller; cancer is limited to the thyroid.

Stage II: Tumor is larger than 2 centimeters and cancer is limited to the thyroid or the tumor is any size and cancer has spread just outside the thyroid, but not to lymph nodes.

Stage III: Tumor is any size and cancer has spread to the lymph nodes near the trachea and larynx and may have spread to other neck tissues.

Stage IV: The tumor is any size; cancer has spread beyond the thyroid to other areas such as the trachea, esophagus, and voice box, may have spread to lymph nodes or distant parts of the body such as lungs and bones

Anaplastic thyroid cancer:

All anaplastic thyroid cancers are considered stage IV because they grow rapidly and are usually not found until they have progressed to the neck. The cancer may have spread to lymph nodes or to distant parts of the body, such as the lungs and bones.

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