What is a thyroid biopsy?

A thyroid biopsy is a diagnostic procedure that involves taking tissue from your thyroid or from nodules that have grown in your thyroid to test it for thyroid cancer or other thyroid conditions. Nodules form in the thyroid for a variety of reasons, many of which are harmless. Only approximately 10 percent of nodules are cancerous.

What are types of thyroid biopsies?

Although most patients receive a fine needle aspiration biopsy, your doctor may also order a core needle biopsy or surgical biopsy.

  • Fine needle aspiration
    A fine needle aspiration is a type of thyroid biopsy that is performed while you are awake. Most patients do not need any anesthesia during this procedure. During the test, your doctor will use imaging guidance to thread a small needle into your neck and remove a sample of thyroid tissue for testing. Your doctor may remove several samples from various areas of the thyroid, nodule or the lymph nodes near the thyroid. The procedure is performed in a clinic setting and lasts approximately 30 minutes. You will be able to resume your daily activities after leaving the clinic.
  • Core needle biopsy
    A core needle biopsy is similar to a fine needle aspiration but involves using a larger needle. It may be performed if the fine needle aspiration does not produce enough information to make an accurate diagnosis.
  • Surgical biopsy
    Rarely, a surgical biopsy on the thyroid is necessary. During a surgical biopsy, your surgeon will cut an incision in the neck to remove the nodule. In some cases, you may need to remove part of the entire thyroid.

Who is a candidate for a thyroid biopsy?

Your doctor may order a thyroid biopsy when:

  • Your blood or imaging test results come back abnormal
  • You have a nodule that is larger than one half inch thick
  • You have a solid nodule without clear borders that appears to have calcium on it
  • You are in extreme pain and the thyroid is enlarging at a rapid pace

A biopsy can definitively diagnose thyroid cancer.

Risks of a thyroid biopsy

Although fine needle and core thyroid biopsies are generally safe procedures, complications can occur. The most common complications include:

  • Discomfort at the biopsy site
  • Bleeding
  • Infection
  • Cyst formation
  • Bruising
  • Fever

Complications associated with a surgical thyroid biopsy may be more severe. A surgical biopsy is a more invasive procedure that involves a longer recovery time and greater risk of complications such as:

  • Severe bleeding
  • Infection at incision sites
  • Bruising
  • Tissue damage
  • Scarring
  • Tingling or numbness over the biopsy area

What to expect during a thyroid biopsy

What to expect during a thyroid biopsy will depend on which thyroid biopsy technique your doctor has chosen for you.

Results from a thyroid biopsy

It can take as long as two weeks for your thyroid biopsy test results to come back. If it is a simple biopsy, the results can be back in a couple of days. If the results indicate cancer, your doctor will develop a treatment plan that is most appropriate for you.
Treatments may include:

  • Alcohol ablation
  • Neck dissection
  • Radioiodine therapy
  • Thyroidectomy
  • Thyroid lobectomy

Recovery after a thyroid biopsy

Most patients can return to work the same day as the thyroid biopsy. You may experience neck discomfort, ear pain or mild bruising for a few days after the procedure.

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