This retrospective review of followup results from patients with non-diagnostic ultrasound guided thyroid biopsy. Of the 393 nodules with non-diagnostic initial result, only 9 were subsequently diagnosed with malignancy with either repeat FNA or surgical excision, and a very low percentage (2/336) had a malignancy diagnosed on repeat sampling. As such the authors propose ultrasound followup in lieu of repeat biopsy.
They further identify higher risk features including size, male gender and increased age.
While the study is limited as it is a retrospective sampling, it does provide some evidence to guide management of a frequent clinical conundrum in the setting of a non-diagnostic FNA.
PICO Analysis:
Population: Patients with initial negative US guided FNA
Intervention: Repeat FNA
Comparison: Followup US
Outcome: Prevalence of missed malignancy
Reference:
Pubmed
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