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Diagnostic yield of nondiagnostic thyroid nodules is not altered by timing of repeat biopsy
Carrie C Lubitz1, Sushruta S Nagarkatti, William C Faquin
1Department of Surgery (Endocrine Surgery Unit), Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. clubitz@partners.org
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).
Conclusion:
The timing of repeat FNAB for an initial ND FNAB does not affect diagnostic yield of the repeat FNAB.