Risk stratification based on thyroid cytology: Can we rely on national data?

PurposeDetermine correlation of malignancy rates between fine needle aspiration (FNA) biopsy and surgical specimen in an urban academic environment.MethodsRetrospective review at an academic medical center of fine needle aspiration biopsies and surgical specimens in a head and neck otolaryngology practice between 2000 and 2012.ResultsOf the 74 biopsies diagnosed as follicular lesion, 34 (45.9%) were malignant. Of the 45 biopsies diagnosed as follicular neoplasm, 22 (48.9%) were malignant. These results are significantly higher than the average risk of malignancy cited by the American Thyroid Association of 5%–10% and 20%–30% for follicular lesions and neoplasms respectively.ConclusionsThe rate of malignancy based on a FNA diagnosis of indeterminate cytology (follicular lesion or follicular neoplasm) can vary greatly among different institutions. Thyroid surgeons should be aware of their local pathology practices to better guide therapy and counsel patients.