She first felt the thyroid mass in September 2012. This was soon followed by a thyroid ultrasound and a biopsy (presumably via an ultrasound guided fine needle aspiration). The biopsy came back cancerous (unclear exactly what type of thyroid cancer). Given the thyroid cancer diagnosis, she underwent a total thyroidectomy. Two weeks later, she went up on-stage and became Miss Oregon 2013 without the benefit of the judges knowing what she had been going through.
She has a midline neck scar from the surgery that is clearly visible once you know it's there.
Read more about the surgery here or watch the video!