Surgery before FNAB

[wbek]

I have several nodules, only one that is solid.  It is 14.5 mm tall and the width is 4.5mm. My thyroid itself is heterogenous. My sister had thyroid cancer, resulting in thyroid removal and followed by radioactive treatment.  I was referred by my PCP for surgery.  The Dr received records/a specialist at dartmouth, and has scheduled a preop appt and than a week later a FNAB.  I asked if I should just do the FNAB and come to the surgeon if the results are cancer and the reply was no, he plans to do surgery either way.  the FNAB will just determine if more tests are needed such as to see if there is lympth node involvement etc?  Does this sound right? Why would they recommend surgery without the FNAB first?

[Mark Lupo, M.D.]

Usually we do the FNA and then decide on surgery unless the nodule/goiter is large and causing symptoms in which case FNA is done to help plan the extent of surgery.

[wbek]

Thanks :) I am going to cancel the preop appointment and wait for the result of the FNAB to decide.  My sister had a bad experience. She had an in office biopsy that was negative and continued for years with a cough and swollen lymph nodes. They kept saying she had bronchitis.  It turned out to be full blown thyroid cancer, wrapped around her vocal cords and her lymph nodes were involved. I think my PCP, who is also her new PCP, is nervous and sent the removal request.  However, I trust the new FNAB technology and will wait and see.

[wbek]

Thanks :)  I think I may cancel the preop appointment since it is a two hour drive and just have them do the FNA and decide from there.

[Gibbon1]

Sounds like you're being railroaded. Unless your thyroid is causing compression symptoms I'd get a second opinion.

A 14mm X 4.5mm nodule is 'small'

[Jeda01]

No, not to me. I mean if your sister has had thyroid cancer then I see why they would want to remove it but if Fnab comes back benign then I would think that you should have the ultimate choice.