Does large needle aspiration biopsy add pain to the thyroid nodule evaluation?

Area of Science:

• Endocrinology
• Interventional Radiology
• Pathology

Background:

• Thyroid large needle aspiration biopsy is often avoided due to perceived pain.
• This perception contrasts with extensive clinical experience.

Purpose of the Study:

• To evaluate and compare the pain associated with fine needle aspiration biopsy (FNAB) versus combined FNAB and large needle aspiration biopsy for thyroid nodules.
• To determine if large needle aspiration biopsy adds significant discomfort.

Main Methods:

• A survey of patients undergoing FNAB or combined FNAB and large needle aspiration biopsy.
• Pain assessment using a 4-point scale (0-3) for unpleasant sensation or pain.
• Comparison of needle gauge and number of punctures between groups.

Main Results:

• No significant difference in pain scores between the FNAB group and the combined FNAB plus large needle aspiration biopsy group.
• Larger needles were used in the combined group, and more punctures were performed.
• Despite increased invasiveness, pain levels remained comparable.

Conclusions:

• Large needle aspiration biopsy following FNAB does not introduce additional pain or discomfort.
• The benefits of large needle aspiration biopsy support its inclusion in thyroid nodule evaluation algorithms.