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January 30, 2020

Surgical Management of Thyroid Nodular Disease—Personal Evolution Throughout 4 Decades of Practice

Author Affiliations
  • 1Mount Sinai Hospital, Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
JAMA Otolaryngol Head Neck Surg. 2020;146(3):223-224. doi:10.1001/jamaoto.2019.4471

As a surgeon who has performed more than 7000 thyroidectomies throughout 4 decades, I have witnessed a significant amount of change. When I started, the premise of surgery for a suspicious mass was based on very little evidence; too many total thyroidectomies were performed, and too much postoperative radioactive iodine was administered. In this Viewpoint, I discuss the significant changes in the treatment of patients with thyroid cancer throughout the last 4 decades.

Over the years, indications for surgery within my practice have changed with an increase in the number of cases performed for biopsy-proven cancer and a decrease in the number performed for clinical/cytological suspicion of cancer and benign disease with risk factors. It is these indications that bear further discussion.

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