1. Should we wait 3 months for a repeat aspiration in non-diagnostic/indeterminate thyroid nodules? A cancer centre experience.
- Author
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Valerio E, Pastorello RG, Calsavara V, Porfírio MM, Engelman GG, Francisco Dalcin J, Bovolim G, Domingos T, De Brot L, and Saieg M
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Regression Analysis, Thyroid Gland pathology, Thyroid Neoplasms pathology, Thyroid Nodule pathology, Biopsy, Fine-Needle, Thyroid Gland diagnostic imaging, Thyroid Neoplasms diagnosis, Thyroid Nodule diagnosis
- Abstract
Introduction: The Bethesda System recommends repeat fine needle aspiration (rFNA) as a management option for nodules classified under the non-diagnostic (ND) and atypia of undetermined significance (AUS/FLUS) categories. We evaluated the impact of an rFNA in diagnostic resolution and the role of early (≤3 months) vs delayed (more than 3 months) rFNA of nodules initially diagnosed as ND and AUS/FLUS., Methods: We retrospectively collected all thyroid FNA performed in a 4-year period with repeat aspiration. For cases initially signed out as ND or AUS/FLUS, diagnostic resolution was defined as a change to a Bethesda System category other than these two on rFNA. Comparison and regression models were fitted to identify the impact of time of rFNA on diagnostic resolution., Results: In total, 184 cases were initially assigned as ND and 143 as AUS/FLUS, with overall diagnostic resolution rates for the reassessment of these nodules calculated at 70.1% and 62.9%, respectively. For ND cases, time of rFNA was not significantly associated with diagnostic resolution (P > .05). For AUS/FLUS nodules, however, repeat aspiration performed in more than 3 months after the initial diagnosis was 2.5 times more likely to achieve a resolution in diagnosis than early rFNA (P = .024)., Conclusions: Repeat aspiration of ND and AUS/FLUS nodules helped define diagnosis for the majority of cases, being highly effective in determining correct patient management. For AUS/FLUS nodules, repeat aspiration performed more than 3 months after the initial diagnosis was associated with a higher diagnostic resolution., (© 2020 John Wiley & Sons Ltd.)
- Published
- 2020
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