Background: The aim of this retrospective analysis is to evaluate the impact of preoperative fine needle aspiration biopsy (FNA) on the thyroid nodules management.
Methods: On a consecutive series of 434 thyroidectomies carried out in the last 3 years, the role of FNA on 139 cases has been statistically evaluated. All cytologic diagnoses have been classified in three subsets: malignant (group 1); suspect (follicular or Hurtle cell proliferation) (group 2); benign (group 3).
Results: Our data confirm previous observations about the high specificity of FNA in case of diagnosis of malignancy (97.6%). On the other hand 51.6% of our cases are included in group 2; only 31.9% of these cases have shown a postoperative diagnosis of malignancy, following a suspect at FNA. In this study, the sensibility of FNA has been calculated including among positive results the cytologic diagnoses of group 1 + group 2: the resulting figure of 87.3% weighs the impact of FNA on our surgical decision process.
Conclusions: FNA plays a crucial role in the management of nodular diseases of the thyroid, even if its overall value is limited by the burden of "suspect" cytologic diagnoses. In our hands, the integration of FNA results with all relevant clinical data has undoubtedly contributed to increase the portion of thyroidectomies carried out for cancer, from 12.8% of our historical series to 23.2% of the last 3 years.