Value of fine‐needle aspiration in evaluating large thyroid nodules

ABSTRACT Background The American Thyroid Association (ATA) recommends using ultrasound‐guided fine‐needle aspiration (FNA) in order to evaluate supracentimetric and suspect thyroid nodules. The purpose of this study was to evaluate the effective use of FNA before surgery for nodules over 3 cm in diameter. Methods In this retrospective study, we analyzed the results of ultrasound‐guided FNA and postoperative histological analysis in 843 nodules >3 cm. Results The FNA was informative in 42.6%. The correlation with the final histological analysis was 94.8% for benign nodules and 71.0% for malignant nodules. The FNA had a positive predictive value of 71%, a specificity of 97%, a sensitivity of 56%, and a 4.7% rate of false‐negative results. Conclusion Because there is a nonnegligible FNA risk of error, notably allowing the evolution of a cancer in 1 of 20 cases, the FNA data should not delay surgical intervention for potentially suspect nodules >3 cm in diameter. © 2016 Wiley Periodicals, Inc. Head Neck 39: 32–36, 2017