Is It Safe For A Fourth Time Operation For Thyroid Cancer?

Hi. I have a history of FVPTC and Renal cell cancer, and most recently Phylloides tumor which was removed with positive margins (waiting on referral for 2nd opinion). My question relates to the thyroid cancer. I was diagnosed in 2012, have had a complete thyroidectomy and a central neck dissection in May of 2013. 2 months later, they detected another recurrence in my suprasternal notch, and have only been monitoring it for the last year. However, recent US results show it has doubled in size to 2.3cm with signifigant blood flow on Doppler. I see my ENT tomorrow. Anyway, recent TG tests show an increase in levels to 10.5. I ve never had RAI, as my Rad Onc decided against it, even after my recurrence last year. Due to the bad US results, my GP has ordered an iodine scan for mid Sept. would I need surgery prior to ablation? They have me off my Synthroid in prep for the scan. My tg has been all over the place the last 2 years. As high as 350, normally hovering around 16 (unstimulated). My last Thyrogen test with PET/CT showed my TG at 273 (Sept 2013). Why I m confused is obviously I need to be treated with RAI, but the cancer agency discharged me without doing so. So now I m going off of instinct instead of medical care! What do you recommend regarding a second neck dissection? Is it safe to operate for the 4th time in that area? Should the doctors on my case be doing more considering my 3 time cancer history?