During the Thyroid BiopsyWhen most people hear the word 'biopsy', they often think it is a surgical procedure that requires an incision. While this can be true with other types of cancer, most thyroid biopsies are performed by fine needle aspiration (FNA). (An open thyroid biopsy, a procedure where an incision is made in the neck to obtain a tissue sample, may be required in some cases but is uncommon.) An FNA thyroid biopsy uses a long, thin needle to obtain a sample of thyroid tissue. It is usually performed by a surgeon or endocrinologist and may be completed in the office or in an outpatient surgical setting. A pathologist may be on hand to ensure an adequate specimen has been taken in order to avoid having to repeat the procedure later.
Your doctor may choose to use an ultrasound to help guide the procedure. Some thyroid nodules are small or are in a location that may be difficult to blindly biopsy. However, some larger nodules may not require the use of ultrasound guidance. The experience of your physician can also play a role in whether they choose to use an ultrasound -- more experienced doctors may not require it.
A local anesthetic may or may not be given. Some doctors use an ice pack to numb the area instead of using an anesthetic. Some patients who have had multiple thyroid biopsies report that the local anesthetic injection hurts worse than the biopsy needle itself. Pain from anesthetic needle is often described as a quick burning sensation. Remember that everyone tolerates pain differently. If you are concerned about pain during the biopsy, talk to your doctor.
First, you will probably be asked to remove your clothing from the waist up and dress in a gown. A sterile cleaning solution is applied to your skin. You will be asked to lie back on an exam table or a reclined medical chair similar to what the dentist uses, and tilt your head back. If your doctor chooses to use a local anesthetic, they will numb the area and wait a few minutes for it to become effective before proceeding.
Once the area has become numb, the doctor will begin the actual biopsy by inserting a long, thin needle into the area needing to be sampled. The actual time that the needle is inserted is only between 5 and 10 seconds. Your doctor may take a few samples, requiring additional needle punctures. The samples are examined by a pathologist to ensure an adequate sample has been taken. Then a bandage will be placed over the biopsy site and you are finished.
After the Thyroid BiopsyMost people who undergo a thyroid biopsy are able to drive after the procedure and return to work the same day. You may experience mild neck discomfort or ear pain up to three days following the biopsy. Mild bruising may occur, especially in fair-skinned individuals.
Thyroid biopsy results are generally available a few days after the procedure. You may want to ask your doctor when the results will return and how you will be notified. Some doctors are comfortable with discussing lab results over the phone, while others choose to do so in the office.