How Accurate Is A Thyroid FNA On Small Nodules?

Dr.Lupo,

How accurate is thyroid FNA especially on small 1cm,and 4,mm and 7 or 8mm nodules?

[Mark Lupo, M.D.]

In experienced hands, FNA is very accurate to about 5mm.
However most of these do not need (and usually should not undergo) FNA.
Observation is usually the best option.

[Gibbon1]

Standard of care seems to simply watch nodules under 1cm. Small nodules are very common. 10-30% of people have them. Cancer is rare and tends to be very treatable.  On the other hand an FNA isn't that bad.

[ch4165]

Thank you again for another nice good response. But,I didn't know at the time 3 years ago, when I had all 3 of my nodules biopsed,that my isthmus nodule,was as small as about 3mm,which has now grown 4mm more in almost three years as I had told you.And I am having another FNA on it at UPenn on April 18th. But in an article on the National Cancer Institute's site in February 2008 about the increase in thyroid cancer,Dr.Michael Tuttle of The Sloan Kettering Cancer Center said that back when he was a fellow in the early 1990's they couldn't easily biopsy a nodule that was 1 centimeter or less,but over the last ten years techniques have advanced such that we can now easily biopsy nodules that are less than 4 or 5 millimeters.

[ch4165]

Thanks again to you too. Actually studies report that up to 50-67% of people have thyroid nodules! Virgina Livosi (I'm not totally sure of the spelling of her last name) a top gynecological and thyroid cancer pathologist at University of Pennsylvania Hospital,called me back 3 years ago and she was very nice. She said that 60% of people walking down Ritten House Square have thyroid nodules,and I said and most of them don't know it,and she said,that's right,and she said if they found out they would be worried about thyroid cancer and want to get FNA's.

[ch4165]

You say that small thyroid nodules shouldn't be biopsed,why is that? I mean most people want and need some peace of mind,and benign and cancerous nodules grow slowly,so it could be *years* before someone gets any idea of what kind of cells are really inside the nodules.