Thyroid Fine Needle Aspiration Biopsy

What is a thyroid fine needle aspiration biopsy?

A thyroid fine needle aspiration biopsy is a procedure that removes a small sample of tissue from your thyroid gland. Cells are removed through a small, hollow needle. The sample is sent to the lab for analysis.

The thyroid gland is in the front of your neck. It is butterfly shaped, with two lobes connected by a narrow band of tissue. It is an endocrine gland that makes thyroid hormone. This hormone has many functions in your body.

In some cases, hard nodules form inside the gland. You might notice a small bump in your gland area. Most times, the nodules are not dangerous. But in some cases they can be thyroid cancer. A thyroid fine needle aspiration biopsy can take a sample from the nodule to test for cancer.

Why might I need a thyroid fine needle aspiration biopsy?

You might need the test to see whether your nodule is cancerous. You might have noticed the nodule yourself, or your healthcare provider might have noticed it during an exam or on another test.

Researchers do not know what causes most thyroid nodules. They are very common, though. Certain problems with the thyroid gland, like Hashimoto’s thyroiditis, may increase your chances of getting a thyroid nodule.

Only a small percentage of thyroid nodules turn out to be cancer. It is important to identify a cancerous nodule as soon as possible, so that you can begin treatment quickly.

Not everyone who has a thyroid nodule needs a fine needle aspiration biopsy. Your healthcare provider may start with an ultrasound or computed tomography (CT) scan of your neck. Sometimes, this provides enough information to know that the nodule isn’t due to cancer. Blood tests of thyroid levels also may provide helpful information. If your healthcare provider can’t tell for sure, you’ll probably need a thyroid fine needle aspiration biopsy.

The procedure is less invasive than open and closed surgical biopsies, which involve larger incisions in your skin. Healthcare providers perform these procedures much less frequently than fine needle aspiration biopsy.

What are the risks of thyroid fine needle aspiration biopsy?

Thyroid fine needle aspiration biopsy is a very safe procedure, but it does carry some slight risks. These include:

  • Bleeding at the biopsy site
  • Infection
  • Damage to the structures near the thyroid

Because most healthcare providers use ultrasound to guide the procedure, this last complication is rare.

There is also a small risk that the fine needle aspiration biopsy will not show for sure whether the nodule is cancerous. If this happens, you might need a repeat biopsy.

How do I prepare for a thyroid fine needle aspiration biopsy?

There is very little you need to do to prepare for a thyroid fine needle aspiration biopsy. Ask your healthcare provider whether you should stop taking any medications before the procedure, like blood thinners. You should be able to eat and drink normally before the procedure. You will probably go to a medical clinic to have the procedure performed. You should be able to go home that same day.

What happens during a thyroid fine needle aspiration biopsy?

Some people, like children, might need a medication to help them relax before the procedure. Most people will not need this, though.

In some cases, your healthcare provider might inject a local anesthetic to the area before inserting the needle. Because the needle is so small, this is often not necessary.

Your healthcare provider may perform the biopsy with the help of an ultrasound machine. This machine uses high-frequency sound waves to provide an ongoing image of the nodule. This enables your healthcare provider to guide the needle to exactly the right spot, and it prevents damage to other structures. A gel-like substance will be applied to your neck, where the ultrasound detector will be used.

After cleaning the area, your provider will insert the thin, fine needle into your thyroid gland. This may hurt a little. He or she will slowly advance the needle into the nodule itself, moving it back and forth several times.

The needle attaches to a syringe that can apply suction and remove some cells from the nodule. After the removal of the needle, these cells will be placed on a slide. Your provider might repeat this procedure a few times to obtain different samples.

After the procedure, the cells will be sent to a pathology lab, where they will be analyzed for signs of cancer. A small bandage will be placed over the needle insertion site.

What happens after a fine needle aspiration biopsy?

Most people will be able to resume their normal activities right away. You can remove your bandage within a few hours.

The site of the biopsy might be sore for a day or two after the procedure. You can take over-the-counter pain medications if you need to. Follow any other specific instructions that your healthcare provider gives you.

It may take several days to get your test results from the pathology lab. Ask your healthcare provider when you can expect to get your results back.

If your thyroid nodule is not cancer, you might not need any further treatment. Your provider may want to monitor your nodule, though, and you might need another biopsy in the future.

You will probably need surgical treatment if your nodule appears cancerous. Luckily, most thyroid cancers are curable.

Sometimes, the pathologist cannot determine for sure whether your nodule is cancer. In this case, your healthcare provider might recommend a repeat biopsy or surgery. Whatever your test results, you can work with your healthcare provider to develop the best possible treatment plan for you.

Next steps

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or procedure
  • The risks and benefits of the test or procedure
  • When and where you are to have the test or procedure and who will do it
  • When and how will you get the results
  • How much will you have to pay for the test or procedure