About Thyroid Fine Needle Aspiration (FNA) Biopsy

Your doctor may order a fine needle aspiration (FNA) biopsy if he or she finds a nodule (lump) in the thyroid.

Thyroid nodules are common and are present in about one-half of all people by ages 50 to 60. FNA is the best diagnostic procedure for determining which thyroid nodules are benign, and which have cancer.

Convenient, Same-Day Testing at the Multidisciplinary Thyroid Center (MTC)

Same-day diagnostic and screening services at the MTC expedite diagnosis and treatment of thyroid cancer and other thyroid diseases.

When you have an FNA biopsy at the MTC:

• Your endocrinologist inserts a very thin needle into your thyroid nodule to remove a tissue sample.
• An onsite cytologist (cell expert) and your physician prepare the sample before you leave, making sure there is enough tissue for examination.
• If your FNA biopsy detects an obvious cancer, you're often able to see the surgeon that same day.

Preparing for your FNA procedure

Prior to your FNA biopsy, you should discuss your medical history with your physician, including:

• Any allergies
• Any medicines that you take on a daily basis (you may need to stop taking some medicines up to one week before the procedure)

What to expect during the procedure

FNA is done with such thin needles that local anesthesia is usually not necessary and discomfort is minimal. However, if the biopsy area is particularly sensitive, local anesthetic can be injected to numb the area of the neck to be biopsied. Though the procedure is quite easily tolerated without the use of numbing medicine, it’s readily available should you need it.

During the procedure, your endocrinologist will:

• Have you lie on your back and place a pillow under your shoulders to extend your neck.
• Clean the site of the biopsy with an antiseptic solution.
• Insert a thin, hollow needle into the nodule using ultrasound imaging to ensure the needle remains on target.
• Extract a sample of cells from the nodule into the needle, which is withdrawn after 15-30 seconds.
• Apply pressure to the biopsy site, after collecting an adequate sample.

FNA of a single nodule takes between 10-20 minutes. Each nodule requiring evaluation is normally aspirated twice in this manner.

Since the needles are so thin, bleeding is usually very minimal and a Band-Aid is not usually necessary. You may feel soreness at the biopsy site for one to two days.

Possible complications of FNA

Although rare, complications of FNA may include:

• Bleeding
• Bruising where the needle was inserted
• Pain after the procedure
• Infection

Post-procedure care

After your FNA biopsy, your endocrinologist will give you post-procedure instructions, which may include details about:

• Returning to normal activity, as tolerated
• Taking pain medicine — such as acetaminophen, ibuprofen, or aspirin — if necessary