title: Are large thyroid nodules classified as benign on fine needle aspiration more likely to harbor cancer?
abstract: BACKGROUND
  Our aim was to investigate whether benign thyroid nodules ≥ 4 cm have a higher malignancy rate.
  
  
  METHODS
  A retrospective review of patients with a nodule and a benign FNAB who underwent thyroidectomy was completed. Patients were divided into two groups; nodule size: < 4 cm or ≥4 cm, and clinical factors, nodule size and rates of malignancy were compared.
  
  
  RESULTS
  337 patients underwent thyroidectomy: 99 had nodules <4 cm (2.8 ± 0.58 cm) and 238 had nodules ≥ 4 cm (5.9 ± 1.97 cm). Seven (2.1%) patients had cancer, 2 (2.0%) with a nodule < 4 cm and 5 (2.1%) with a nodule ≥ 4 cm (p = 0.962). There was no difference in clinical factors between groups (p > 0.05).
  
  
  CONCLUSIONS
  There is no difference in rates of malignancy for nodules < 4 cm or ≥ 4 cm. Thus, thyroidectomy should not be recommended based solely on nodule size.
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA.
authors.forename: Helen
authors.initials: H
authors.lastname: Shi
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA; Department of Surgery, University Hospitals Case Medical Center, Cleveland, OH, 44106, USA.
authors.forename: Iulianna
authors.initials: I
authors.lastname: Bobanga
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA; Department of Surgery, MetroHealth Medical Center, Cleveland, OH, 44109, USA. Electronic address: cmchenry@metrohealth.org.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: McHenry
mesh_terms: D044963:Biopsy, Fine-Needle; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000601:surgery; D016606:Thyroid Nodule / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy
keywords: False-negative rate; Fine-need aspiration biopsy; Nodular thyroid disease; Thyroid cancer; Thyroidectomy