Diagnostic yield of nondiagnostic thyroid nodules is not altered by timing of repeat biopsy.
BACKGROUND
Guidelines from the National Cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference recommend a repeat fine-needle aspiration biopsy (FNAB) after 3 months for thyroid nodules with a nondiagnostic (ND) result. Our aims were to assess which factors influenced their clinical management and to determine if the timing of the repeat FNAB affects the diagnostic yield.


METHODS
A retrospective institutional review of 298 patients from 1/2006 to 12/2007 with an ND FNAB was performed. The factors influencing the next step in management, including age, gender, history of radiation, presence of Hashimoto's thyroiditis, thyroid-stimulating hormone levels, and ultrasound characteristics, were evaluated. The effect of the time of the repeat FNABs on their diagnostic yield was assessed.


RESULTS
Of the 298 patients in our cohort, 9% were referred directly for surgery, 76% had a repeat FNAB, and 15% were observed. Tumor size was the only independent variable correlated with treatment strategy after a ND FNAB. There was not a significant difference in diagnostic yields between repeat FNABs performed earlier than 3 months compared to those preformed later (p=0.58).


CONCLUSIONS
The timing of repeat FNAB for an initial ND FNAB does not affect diagnostic yield of the repeat FNAB.
Department of Surgery (Endocrine Surgery Unit), Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. clubitz@partners.org
Carrie C
CC
Lubitz
Sushruta S
SS
Nagarkatti
William C
WC
Faquin
Anthony E
AE
Samir
Maria C
MC
Hassan
Giuseppe
G
Barbesino
Douglas S
DS
Ross
Gregory W
GW
Randolph
Randall D
RD
Gaz
Antonia E
AE
Stephen
Richard A
RA
Hodin
Gilbert H
GH
Daniels
Sareh
S
Parangi
D000368:Aged; D044963:Biopsy, Fine-Needle; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011878:Radiotherapy; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology*; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000473:pathology* / Q000628:therapy; D013965:Thyroidectomy; D013972:Thyrotropin / Q000097:blood; D013997:Time Factors; D014463:Ultrasonography
D013972:Thyrotropin