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Stages and types of thyroid cancer

TNM staging for thyroid cancer

The stage of a cancer tells you about its size and whether it has spread. Doctors use the TNM system to stage thyroid cancer. TNM stands for tumour (T), node (N) and metastasis (M).

Staging thyroid cancer

Knowing the stage of a cancer helps your doctor to decide which treatment you need.

Your doctor works out your TNM stage by looking at tissue from your thyroid and the results of your scans. It might not be possible to fully stage your cancer until after your surgery.

Doctors may also use another system called the number staging system. This system divides cancers into 4 groups, from stage 1 to stage 4.

Read about the number staging system

Tumour (T)

T describes the size of the cancer. 

T0

This means there is no sign of a cancer.

T1

This means the cancer is within the thyroid gland and is 2cm or less. T1 tumours are further divided into T1a and T1b.

T1a

T1a means the cancer is completely inside the thyroid. It is1cm across or smaller.

Diagram showing stage T1a thyroid cancer.

T1b

T1b means the cancer is completely inside the thyroid. It is between 1cm and 2cm across.

Diagram showing stage T1b thyroid cancer.

T2

T2 means the cancer is completely inside the thyroid. It is more than 2cm but no greater than 4cm across.

Diagram showing stage T2 thyroid cancer .

T3

T3 is divided into T3a and T3b.

T3a

T3a means the cancer is more than 4cm across. It is still completely inside the thyroid.

Diagram showing T3a thyroid cancer .

T3b

T3b means the cancer is any size. It has grown outside the thyroid into one or more of the muscles beside the thyroid (strap muscles).

Diagram showing stage T3b thyroid cancer.

T4

T4 cancers have grown outside the thyroid and are divided into T4a and T4b.

T4a

T4a means the cancer has grown outside the thyroid into nearby soft tissue, such as the voice box (larynx), windpipe (trachea), food pipe (oesophagus) or the voice box nerve (recurrent laryngeal nerve).

Diagram showing stage T4a thyroid cancer.

T4b

T4b means the cancer has grown outside the thyroid into the area surrounding the bones of the spine or one of the main blood vessels in the neck area.

Diagram showing stage T4b thyroid cancer.

Node (N)

N describes whether the cancer has spread to the lymph nodes. 

  • N0 means that the cancer hasn't spread to nearby lymph nodes.

  • N1 means the cancer has spread to nearby lymph nodes. It is divided into 1a and 1b

N1a

N1a means the cancer has spread to lymph nodes close to the thyroid in the neck. These are called the pretracheal, paratracheal, and prelaryngeal lymph nodes. Or it has spread to lymph nodes in the upper chest. These are the superior mediastinal lymph nodes. 

Diagram showing stage N1a thyroid cancer.

N1b

N1b means the cancer has spread to other lymph nodes in the neck. These are called cervical lymph nodes. Or it has spread to lymph nodes behind the throat, called the retropharyngeal lymph nodes.

Diagram showing stage N1b thyroid cancer.

Metastases (M)

Metastases describes whether the cancer has spread to a different part of the body.

  • M0 means the cancer hasn’t spread to another part of the body.

  • M1 means the cancer has spread to another part of the body, such as the lungs or bones.

Diagram showing stage M1 thyroid cancer.

Find out more about the stages of cancer

Last reviewed: 02 Aug 2023

Next review due: 03 Aug 2025

Stages and types of thyroid cancer

The type of thyroid cancer refers to the type of cell the cancer started in. The stage of a cancer tells you its size and whether it has spread.

Tests for thyroid cancer

You might have an ultrasound or a needle biopsy to diagnose thyroid cancer.

Treatment for thyroid cancer

Possible treatments include surgery, radiotherapy, targeted drugs and chemotherapy. What treatment you have depends on your type and stage of thyroid cancer.

Survival for thyroid cancer

Survival for thyroid cancer depends upon the type and stage of your thyroid cancer. Survival is generally very good for papillary and follicular thyroid cancers.

What is thyroid cancer?

Thyroid cancer is when abnormal cells in the thyroid gland start to divide and grow in an uncontrolled way.

Thyroid cancer main page

The thyroid is a small butterfly shaped gland that makes and releases hormones. It’s found at the front of your neck in the lowest part.

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