title: SHOULD FNA BE PERFORMED IN PATIENTS WITH A MULTINODULAR GOITER AND COMPRESSIVE SYMPTOMS?
abstract: OBJECTIVE
  In this study, we aimed to determine whether preoperative thyroid fine-needle aspiration (FNA) in patients with multinodular goiter (MNG) and compressive symptoms influences the type of thyroid surgery performed, the incidence of recurrent thyroid cancer, or the need for successive surgery.
  
  
  METHODS
  We retrospectively reviewed the charts of 431 patients who underwent thyroidectomy at our institution from 2008 to 2011. Patients who presented with compressive symptoms and no prior FNA at initial presentation were included in this study.
  
  
  RESULTS
  Eighty patients met the criteria for our study, of which 46 (57.5%) underwent FNA prior to surgery and 34 (42.5%) were referred to surgery without FNA. The prevalence rates of malignancy (>1 cm) on surgical pathology in the FNA and non-FNA groups were 41% (n = 19) and 38% (n = 13), respectively. There was no statistically significant difference between the rate of total/subtotal thyroidectomies (71.7% in FNA vs. 79.4% in non-FNA, P = .31), lobectomies/partial thyroidectomies (28.3% in FNA vs. 20.5% in non-FNA, P = .43), neck lymph node dissections (P = .89) or subsequent surgeries (P = .72) between the 2 groups.
  
  
  CONCLUSIONS
  Our findings show that preoperative FNA in patients with an MNG and compressive symptoms does not influence the type of surgery performed, short-term outcomes, or the need for subsequent surgeries. Further studies are needed to validate the need for preoperative FNA in such patients.
  
  
  BACKGROUND
  FNA = fine-needle aspiration MNG = multinodular goiter WHO = World Health Organization.
authors.forename: Dana Chanes
authors.initials: DC
authors.lastname: Manuel
authors.forename: Jessica Lee
authors.initials: JL
authors.lastname: Betancourt
authors.forename: Nitin Dk
authors.initials: ND
authors.lastname: Puthanveedu
authors.forename: Sergey
authors.initials: S
authors.lastname: Kachur
authors.forename: Sandra F
authors.initials: SF
authors.lastname: Williams
authors.forename: Jose M
authors.initials: JM
authors.lastname: Cabral
authors.forename: Carmen V
authors.initials: CV
authors.lastname: Villabona
authors.forename: Tessey C
authors.initials: TC
authors.lastname: Jose
mesh_terms: D044963:Biopsy, Fine-Needle / Q000706:statistics & numerical data; D003251:Constriction, Pathologic / Q000209:etiology / Q000473:pathology; D005260:Female; D006044:Goiter, Nodular / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy; D014132:Trachea / Q000473:pathology*