Do you have an inconclusive thyroid biopsy? When you take a fine needle aspiration (FNA) biopsy of the thyroid, and the result comes back inconclusive or indeterminate, your initial reaction may be fear or worry. You want to know what’s going on with your thyroid. However, don’t give up yet, because there are things you can do after receiving such news.
Inconclusive Thyroid Biopsy | What to Do Next
1. Consult an Endocrinologist
If an internist or family practitioner ordered your FNA, then you can discuss your FNA results with an endocrinologist. Your endocrinologist will usually recommend you undergo a trial of thyroid hormone therapy for six to eight months. After your trial therapy, your endocrinologist might recommend getting another FNA biopsy.
Getting a second opinion is always a good thing. You can also consult a pathologist with special interest or training in thyroid diseases to take a look at the smears from your first FNA.
2. Retake the FNA Biopsy
An inconclusive biopsy means there is no certainty of whether a thyroid nodule is malignant. Instead, it simply means the FNA was unable to determine the nature of your lump. There is the possibility the nodule is cellular but not suspicious of malignancy, hence the indefinite result. In this case, the FNA should be repeated.
3. Have an Ultrasound for your Thyroid
If your FNA biopsy continues to come out inconclusive, you can always have an ultrasound for your thyroid nodule. It’s a harmless and painless procedure and requires no preparation beforehand.
An ultrasound will produce pictures of your thyroid gland to analyze its appearance. From this, your physician can determine if the nodule is a common benign growth or if further action must be taken.
4. Full Thyroidectomy
A full thyroidectomy is the surgical removal of the thyroid gland in order for a pathologist to examine it closely. As a result, they’ll be able to evaluate the thyroid gland and also check for the presence of cancer.
However, it’s good to keep in mind that only 20 percent of inconclusive results turn out to be malignant. Consequently, this results in the unnecessary removal of thyroid glands from the patients. Since they no longer have their thyroid glands, these patients end up with lifelong hypothyroidism. This option can be very risky.
5. Veracyte Afirma Thyroid Analysis
Afirma Thyroid Analysis from Veracyte Helps Patients Avoid Unnecessary Thyroid Surgery for… http://t.co/BO29rIAA48
— Lisa Davis Budzinski (@lisadbudzinski) January 25, 2014
Veracyte Afirma Thyroid Analysis is a new test for eliminating inconclusive or indeterminate FNA results. It’s similar to conducting an FNA, but it involves dividing 4-5 samples for use in two tests. The samples will be sent to Thyroid Cytopathology Partners for an initial cytopathology for a more specific biopsy. If the cytopathology is indeterminate, they will send the other half of the samples to a genomic test which measures gene expression patterns.
If you’re going for an FNA for a thyroid nodule, talk to your doctor beforehand about the Veracyte Afirma Thyroid Analysis process before undergoing a thyroidectomy.
Watch this video from Cleveland Clinic to find out how fine needle aspiration biopsy is done with the aid of an ultrasound!
If you have a thyroid disorder, especially Hashimoto’s thyroiditis, you’re usually at risk of developing thyroid cancer. The growing thyroid nodule could be the first sign. It’s important to have your thyroid nodule checked and diagnosed in order to begin treatment. If your results come out inconclusive, then you can try one of the options above. An FNA may not always be accurate, but there are other tests you can take to have a more accurate diagnosis of your thyroid nodule.
Have you had an inconclusive thyroid biopsy? What actions did you take after you received your results? Share your experience in the comments below!