Thyroid Micro-Nodules Seen on Ultrasound Need Biopsies?
There is no rush to biopsy or surgery for micro-nodules seen on Ultrasound without presence of lymph node disease. Deferred biopsy and surgery did not impact survival.
Richard Guttler MD,FACE,ECNU
Endocrine. 2015 Aug;49(3):735-44.
1.The incidence of small thyroid malignancy has increased.
2.However, there is no evidence-based guideline for managing thyroid nodules ≤ 5 mm on ultrasonography (US).
3.We evaluated how to manage thyroid nodules ≤ 5 mm. Thyroid nodules ≤ 5 mm in size on US that had undergone surgery and US-guided fine-needle aspiration were eligible.
4. A total of 3,117 thyroid nodules in 3,012 patients were included.
5. Only 5.8 and 1.2 % of malignant nodules and 6.8 and 4.2 % of benign nodules increased in size when a 2-mm and 3-mm change on US were referenced.
6. 1,079 patients with an index malignancy ≤ 5 mm, extrathyroidal extension, lymph node metastasis, recurrence, and mortality were not significantly different between patients with and without follow-up and between patients with surgery within 12 months and after 12 months.
7. None of the patients who underwent surgery had distant metastasis and none died of thyroid malignancy.
8. In thyroid nodules ≤ 5 mm found on US, US-FNA could be recommended in cases of increased size during US follow-up if lateral LNM was not found because a delay in surgery did not impact cancer recurrence and mortality.