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What is an FNA biopsy of the thyroid, parathyroid, or lymph node? How is it performed?

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An FNA biopsy or fine needle aspiration is a sample of tissue that is obtained with a very small needle taken using ultrasound guidance that the pathologist can evaluate. Dr. Brady, local thyroid and parathyroid surgeon in the Austin area, performs these if indicated in their offices at the initial consultation with their thyroid and parathyroid patients. After identifying the lesion or lesions to be sampled, they will prep or clean the skin on the neck and inject some local anesthetic or numbing medicine. With the ultrasound guiding them, they advance the needle in the numb area into the nodule that needs to be sampled. They then prepare several slides for the pathologist to study under the microscope. This procedure is extremely important for determining if thyroid nodules are benign (non-cancerous) or malignant (cancerous). Dr. Brady usually take 10-15 minutes to perform these biopsies. The FNA biopsy is helpful in sampling lymph nodes for metastatic disease also. The patient can go back to work and drive home after the procedure. Dr. Brady will recommend ice packs to be used for minimizing swelling and soreness after the biopsy. Within 48-72 hours, they will obtain a result from the pathologist and will call the patient with results and a plan for the patient.

When does Dr. Brady recommend an FNA biopsy of a thyroid nodule?

Usually any thyroid nodule that measures 1cm or greater needs an FNA biopsy to ensure it is benign and can be followed without a thyroid surgery. If a nodule has suspicious features such as increased blood supply, irregular borders, calcifications, signs of enlargement or the patient has a history of radiation exposure to the neck, Dr. Brady, Austin’s finest local thyroid and parathyroid surgeon, always recommends an FNA biopsy. In these cases a biopsy is required even if the nodule is less than 1cm. Another group of patients that will likely need an FNA biopsy of thyroid nodules are those with a personal history of any cancer or family history of thyroid cancer. It is rare, but some other types of cancer can metastasize to the thyroid gland with the most common being kidney, breast, lung, gastrointestinal tract or melanoma.

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