How a Thyroid Biopsy Works

What to Expect Before, During, and After a Thyroid Biopsy

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A thyroid biopsy is a common procedure that's performed to investigate a nodule or mass that's found in the thyroid gland. To determine whether the growth is benign or malignant, a doctor must take a sample of cells from the mass.

Biopsy Types

There are a couple of different biopsy types when it comes to the thyroid. When most people hear the word 'biopsy', they often think that 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 a process known as fine needle aspiration (FNA).

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 that an adequate specimen has been taken in order to avoid having to repeat the procedure later.

It should be noted that there are some rare situations in which an open thyroid biopsy may be necessary. An open thyroid biopsy is a procedure where an incision is made in the neck to obtain a tissue sample.

What Happens Before a Thyroid Biopsy

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 on your back on an exam table or in a reclined medical chair that's similar to what a dentist uses, and tilt your head back.

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 an 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. If your doctor chooses to use a local anesthetic, he or she will numb the area and wait a few minutes for it to work before proceeding.

What Happens During a Thyroid Biopsy

Once the area has become numb, the doctor will begin the actual biopsy by inserting a long, thin needle into the area that needs to be sampled. The needle is inserted for just five to 10 seconds. Your doctor may take a few samples, requiring additional needle punctures.

Your doctor may choose to use an ultrasound to help guide the procedure. This is because 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 he or she chooses to use an ultrasound—more experienced doctors may not require it.

The samples are examined by a pathologist to ensure that an adequate sample has been taken. Then a bandage will be placed over the biopsy site and you are finished.

What Happens After a Thyroid Biopsy

Most people who undergo a thyroid biopsy are able to drive home 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. Be sure 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.