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40

NCCN Guidelines for Patients

®

:

Thyroid Cancer, Version 1.2017

5

Treatment guide

Papillary thyroid cancer

Guide 9. Papillary found on an FNA biopsy

Primary treatment Consider after treatment Next steps of care

Lobectomy with

removal of the

isthmus

ª

• Tumor larger than 4 cm

• Positive margins

• Vascular (blood vessels)

invasion

• Spread of cancer in the neck

area

ª

• Complete thyroidectomy

ª

• Negative margins

• No cancer in the other

thyroid lobe

• (NIFTP)

n

on

i

nvasive

f

ollicular

t

hyroid neoplasm

with

p

apillary-like nuclear

features

ª

• Check Tg 6 to 12 weeks

after surgery to plan follow-

up care

• Consider levothyroxine

therapy to keep TSH low or

normal

Total thyroidectomy

ª

• Care after surgery

(See Guides 15 and 16)

Guide 9

shares the first treatment options for

papillary thyroid cancer found on FNA. This is called

primary treatment. Surgery is the primary treatment

option for papillary thyroid cancer. Before surgery,

your doctors consider many factors like whether

you need a lobe of the thyroid removed or the

whole thyroid removed. This depends on the size

and location of the cancer and whether or not it has

spread.

Once surgery is complete, the tumor size and any

remaining disease will be factors in your next steps

of care. This may include more surgery or further

testing to monitor your health. Your doctor may also

recommend that you take levothyroxine to replace

the hormones normally made by the thyroid. It is

helpful to ask your doctor for more information on

surgery. You can also find out what you can expect

when it comes to your care after surgery.