Screening for thyroid malignancy: the role of fine‐needle biopsy

Khafagi, Frederick A.; Wright, G.; Castles, H; Perry-Keene, Donald; Mortimer, Rebecca

doi:10.5694/j.1326-5377.1988.tb120629.x

Cited by 32 publications

(15 citation statements)

References 17 publications

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“…One study found that 27% of the nodules smaller than 1.5 cm were nondiagnostic [11]. In the same study, 16% of the nodules 1.5±3 cm and 13% of nodules larger than 3 cm were nondiagnostic.…”

Section: How Often Do Nondiagnostic Results Occur?mentioning

confidence: 89%

“…In one case series, the researchers reported a nondiagnostic rate of 23% before implementing a bedside evaluation strategy to immediately repeat nondiagnostic results [11]. These authors reported dropping the nondiagnostic results to 12% after the bedside evaluation was in place.…”

Section: How Often Do Nondiagnostic Results Occur?mentioning

confidence: 99%

“…Additionally, nearby lymph glands are palpated to detect enlargement [11,12]. The examiner asks whether the patient has noticed the nodule, how long it has been present, and whether the patient has a hoarse voice or has had dif®culty in swallowing.…”

Section: Screening Testsmentioning

confidence: 99%

“…The cancer probability depends on the criteria used to act on FNA results. Some investigators report that only the malignant category prompted surgery, but in many studies all patients with a suspicious or follicular FNA result are also taken to surgery [11,13,25,26,33].…”

Section: Con®rmatory Test: Fine-needle Aspirationmentioning

confidence: 99%

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Screening high‐risk populations for thyroid cancer*

Eden

Mahon

Helfand

2001

Med. Pediatr. Oncol.

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Regardless of type of exposure, testing initially with ultrasound detects several times more cases of thyroid cancer than palpation. However, when ultrasound is the initial test, many more patients also have surgery for nonmalignant nodules. Screening with palpation is not very reassuring, particularly to medically irradiated patients with negative tests, since almost half (46%) of these patients may have undetected nodules.

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Section: How Often Do Nondiagnostic Results Occur?mentioning

confidence: 89%

Section: How Often Do Nondiagnostic Results Occur?mentioning

confidence: 99%

Section: Screening Testsmentioning

confidence: 99%

Section: Con®rmatory Test: Fine-needle Aspirationmentioning

confidence: 99%

See 2 more Smart Citations

Screening high‐risk populations for thyroid cancer*

Eden

Mahon

Helfand

2001

Med. Pediatr. Oncol.

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“…FNAC has proved to be the most accurate method for the diagnosis of nodular thyroid lesions for more than 20 years, although some problems remain unsolved. In particular, in the various published series, sensitivity and specificity – the two main values used to indicate the accuracy of the method – vary, respectively, from 65% to 98% 14,15 and 72% to 100% 16,17 . This depends mainly on how the cases diagnosed as suspect are considered: if they are inserted in the calculation as positives, the sensitivity increases and the specificity decreases, and vice versa if they are inserted in the calculation as negatives.…”

Section: Discussionmentioning

confidence: 99%

Fine needle aspiration cytology of the thyroid: a comparison of 5469 cytological and final histological diagnoses

Sangalli

Serio²,

Zampatti³

et al. 2006

Cytopathology

128

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Our study confirmed the great efficacy of thyroid FNAC. A cytological diagnosis of Hurthle cell neoplasm should be considered an indicator of high risk. Awareness that failure to recognize the follicular variant of papillary carcinoma was the main problem in the interpretation of thyroid FNAC should lead to a decrease of false-negative diagnoses. The inadequate rate was very low, as it was the pathologist personally who performed the needle aspiration.

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The Cost of Screening for Synchronous Thyroid Disease in Patients Presenting With Primary Hyperparathyroidism

Hollenbeak

Lendel

Beus

et al. 2007

Arch Otolaryngol Head Neck Surg

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To use decision analysis to compare the costs associated with minimally invasive parathyroidectomy (MIP) and bilateral neck exploration (BNE) in patients with primary hyperparathyroidism with regard to treatment of incidental synchronous thyroid disease. Design: We developed a decision tree model to evaluate the cost of managing thyroid pathology in primary hyperparathyroidism with the following 3 approaches: MIP, MIP with preoperative ultrasonography, and routine BNE with intraoperative thyroid evaluation. We tested the robustness of the optimal decision with sensitivity analyses. Setting: A tertiary care academic medical center. Main Outcome Measure: Total costs from a provider perspective. Results: Minimally invasive parathyroidectomy without an active search for thyroid abnormalities was determined to have the lowest expected cost ($5275 per patient). Parathyroid surgery with routine preoperative thyroid ultrasonography and further thyroid treatment as indicated had an expected cost of $5910 per patient. Bilateral neck exploration with intraoperative thyroid evaluation and treatment of the thyroid gland had an expected cost of $5916 per patient. Sensitivity analyses confirmed the robustness of the results across a reasonable range of surgical and imaging costs. Conclusions: Minimally invasive parathyroidectomy is not contraindicated on the basis of cost by an inability to screen for synchronous thyroid disease. In addition, ultrasonographic screening of the thyroid glands of patients undergoing MIP is not cost prohibitive and, in fact, is less costly than BNE. Ultrasonography has the added advantage of confirming the location of the offending parathyroid.

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Screening for thyroid malignancy: the role of fine‐needle biopsy

Cited by 32 publications

References 17 publications

Screening high‐risk populations for thyroid cancer*

Screening high‐risk populations for thyroid cancer*

Fine needle aspiration cytology of the thyroid: a comparison of 5469 cytological and final histological diagnoses

The Cost of Screening for Synchronous Thyroid Disease in Patients Presenting With Primary Hyperparathyroidism

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