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Ultrasound-guided thyroid biopsy eases concern

Diagnosis of a thyroid nodule is the most common endocrine problem in the United States. While more than 95 percent of such nodules are not cancerous, evaluation using ultrasound guided biopsy can ease concerns.

“A thyroid nodule, or lump, can develop within an otherwise normal thyroid gland,” said Barbara Boyer, M.D., general surgeon, Marshfield Clinic Minocqua Center. “Some nodules can be felt or seen quite easily and are discovered by patients. A vast majority has no symptoms, so your doctor may find the nodule during an examination or diagnostic imaging of the neck done for other health reasons.”

When a nodule is discovered, evaluation is done. An ultrasound of the nodule can indicate size, any concerning features, and whether there is more than one. A blood test is often done to check for proper thyroid function. Results of both tests will determine whether a biopsy is needed.

“Thyroid fine needle aspiration biopsy, usually guided by ultrasound, is a non-surgical method available, which can differentiate cancerous and benign nodules,” said Dr. Boyer. “It can be safely performed in your doctor’s office with minimal discomfort and without intravenous (IV) administered sedation. Patients can return to normal activities the same day.”

During the fine needle aspiration procedure, the patient receives numbing medicine to the neck area where the thyroid is located. The nodules are viewed with ultrasound to provide precise direction as a thin needle is gently inserted to withdraw cells.

“It was an easy procedure to undergo,” said Angie Timmerman, Woodruff. Timmerman recently completed the evaluation of a thyroid nodule she found. “The process, from the initial exam and blood test through biopsy, went quickly.”

The biopsy may cause neck bruising or discomfort, Dr. Boyer said.

Thyroid biopsy results are listed as nondiagnostic or indeterminate; benign (not cancerous) or cancerous. Nondiagnostic results mean not enough thyroid cells were collected during the fine needle aspiration to make diagnosis possible. In these cases, the procedure may be repeated.

Biopsy results can help you and your doctor determine next steps, if any. If the nodule is benign, it is generally followed by ultrasound periodically to ensure it remains unchanged. A more invasive measure, partial removal of the thyroid gland, may be considered if the biopsy results are concerning.

“I was concerned about finding a thyroid nodule,” said Timmerman. “Now I have answers to my questions, which has eased my mind.”