Nondiagnostic thyroid fine-needle aspiration biopsies are no longer a dilemma.
BACKGROUND
Nondiagnostic fine-needle aspiration biopsy (ND-FNAB) of the thyroid leads to unnecessary thyroidectomy. The aims of this study were as follows: (1) to determine the risk of malignancy in ND-FNABs, and (2) to evaluate factors that may identify patients at risk for a ND-FNAB.


METHODS
A total of 241 patients who underwent FNAB and thyroidectomy were evaluated for factors associated with a ND-FNAB.


RESULTS
A total of 215 women and 26 men underwent FNAB and thyroidectomy. ND-FNAs occurred in 51 of 241 (21%) patients. Ultrasound guidance did not reduce the likelihood of a ND biopsy. Patients with nodules greater than 3 cm had more ND-FNAs. Twenty-one of 51 with a ND biopsy underwent a repeat FNAB. Repeat FNAB was ND in 29% of patients. There was malignant disease in 7 of 51 (14%) with a ND-FNAB. Patient age, sex, thyroid function, gland size, multiple nodules, and final pathology were not related to a ND-FNAB (P > .05).


CONCLUSIONS
Most patients with a ND-FNAB have benign disease and low-risk patients with a ND-FNAB on repeat FNA warrant a more conservative approach.
Department of Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA. richards.melanie@mayo.edu
Melanie L
ML
Richards
Elizabeth
E
Bohnenblust
Kenneth
K
Sirinek
Juliane
J
Bingener
D000328:Adult; D044963:Biopsy, Fine-Needle; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013961:Thyroid Gland / Q000473:pathology*; D016606:Thyroid Nodule / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy