Consistency of sequential needle biopsy findings for thyroid nodules. Management implications.

Needle biopsy can reduce unnecessary surgery for thyroid nodules. However, needle biopsy diagnoses of "benign" may be erroneous. Thyroxine may produce regression in such nodules, but usually does not. Some authorities advise surgery for nonresponding nodules; others rely on repeat needle biopsy. In 246 patients, diagnoses by repeat needle biopsy confirmed 85% of the original diagnoses by needle biopsy. Initial benign diagnoses by needle biopsy were confirmed for 187 (91%) of 205 patients. Fourteen had surgery; all nodules were benign. Changes in diagnosis from benign to suspicious by needle biopsy were made for 12 patients; five had surgery, one had a Hürthle cell carcinoma. Changes in diagnosis from benign to malignant by needle biopsy were made in six patients; five had surgery, all lesions were malignant. Reliance on repeat needle biopsy is preferable to routine surgery for nodules not responding to thyroxine.