Premium
Contemporary diagnostic approach to the thyroid nodule
Author(s) -
Rosen Jennifer E.,
Stone Michael D.
Publication year - 2006
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20701
Subject(s) - medicine , thyroid nodules , nodule (geology) , thyroid cancer , thyroid , malignancy , radiology , biopsy , medical diagnosis , incidence (geometry) , indeterminate , pathology , paleontology , physics , mathematics , pure mathematics , optics , biology
Thyroid nodules are common, with an estimated incidence of 5%–10% in the United States. The current gold standard for diagnosis is fine needle aspiration biopsy (FNAB). The incidence of indeterminate diagnoses varies from 10% to 25%. Surgical resection is usually indicated to exclude the diagnosis of cancer in these patients. However, only a minority (about 20%) of indeterminate thyroid nodules actually harbor a malignancy, resulting in surgery for diagnostic purposes alone in many patients. The increased detection of benign nodules and microcarcinomas reinforces the need for improved non‐operative methods to differentiate benign from malignant disease and discriminate low‐risk from high‐risk cancers. In this article we present a current, rational diagnostic approach to the patient with a thyroid nodule, evaluate new advances including thyroid genomic and predictor models, and propose the development of prospective trials to incorporate these new additions into clinical decision making. Given how many questions still exist for patients with thyroid nodules, partnership and collaboration, or the “bench to bedside” concept should find its way into most every thyroid surgeon and endocrinologist's lexicon. J. Surg. Oncol. 2006;94:649–661. © 2006 Wiley‐Liss, Inc.