title: An evaluation of the diagnostic efficacy of fine needle aspiration biopsy in patients operated for a thyroid nodular goiter.
abstract: BACKGROUND
  Thyroid cancer (TC) comprises 1% of all carcinomas and is the most common malignancy of the endocrine system. The disease is more common in women, with its peak morbidity observed in 40-50-year-old patients. The main risk factors include radiation, iodine deficiency, hereditary background, and genetic mutations. Among all diagnosed thyroid nodules, 5%-30% will evolve into cancer. The gold-standard procedure in the preoperative evaluation of a nodular goiter, apart from ultrasonography, is fine needle aspiration (FNA) biopsy. The FNA biopsy is favored for its simplicity, safety, and high specificity and sensitivity rates.
  
  
  OBJECTIVE
  The aim of our study was to evaluate the clinical efficacy of FNA based on the patients' register.
  
  
  METHODS
  In the Department of Surgery at the 4th Military Teaching Hospital in Wroclaw, 2,133 patients underwent thyroid surgery for thyroid goiter between 1996 and 2015. One hundred and eight cases of TC were diagnosed and of these, 66 patients had a preoperative FNA.
  
  
  RESULTS
  Fourteen FNA biopsies (21%) revealed cancer, all of which were confirmed in the postoperative histopathology, although six cases of FNA-diagnosed cancer revealed a different histological type postoperatively. Eighteen FNA biopsies (27%) were suspected of being malignant. A disturbingly high rate of "benign" FNA biopsies (32 cases; 48%) revealed TC after surgery.
  
  
  CONCLUSIONS
  It is of great importance that the quality and quantity of FNA biopsies that are performed have been improved, especially due to the wide adoption of the Bethesda cytological evaluation system. FNA biopsy remains an obligatory and valuable diagnostic tool in thyroid nodules, but it is still insufficient as a standard procedure. A preoperative biopsy should always be related to all the available clinical data in order to provide the best treatment option for each patient individually.
authors.affiliation: Department of Surgery, 4th Military Teaching Hospital; Department of Clinical Nursing, Division of Nursing in Surgical Procedures.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Janczak
authors.affiliation: Department of Surgery, 4th Military Teaching Hospital.
authors.forename: Wiktor
authors.initials: W
authors.lastname: Pawlowski
authors.affiliation: Department of Surgery, 4th Military Teaching Hospital; Department of Clinical Basics of Physiotherapy.
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Dorobisz
authors.affiliation: Department of Palliative Care Nursing, Faculty of Health Science.
authors.forename: Dawid
authors.initials: D
authors.lastname: Janczak
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Karolina
authors.initials: K
authors.lastname: Dorobisz
authors.affiliation: Department of Surgery, 4th Military Teaching Hospital.
authors.forename: Michal
authors.initials: M
authors.lastname: Leśniak
authors.affiliation: Department of Surgery, 4th Military Teaching Hospital.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Ziomek
authors.affiliation: Department of Surgery, 4th Military Teaching Hospital; Department of Clinical Nursing, Division of Nursing in Surgical Procedures.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Chabowski
keywords: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC); fine needle aspiration biopsy; goiter; thyroid cancer