Thyroid Nodule Clinic

Who performs the biopsy? Is it the same physician that makes the treatment decisions?

At Houston Thyroid and Endocrine, our thyroid-trained physicians themselves are involved from start to finish with each patient's evaluation. Since the endocrinologist him or herself performs the the biopsy, there can be a dramatic positive impact on the interpretation of results and management of the nodule as there is not "third-party" disjointed care involved in the decision making. Long term followup can easily be decided.

Is genetic testing offered for indeterminate biopsies ?

Since 2011 this new testing has changed how thyroid biopsies are interpreted. This testing reduces the need for unnecessary surgeries. We offer all major thyroid FNA gene tests and we know how to interpret that information. We know the strengths and weaknesses of all the major genetic tests and can help wisely choose the best for your situation.

Prior to the biopsy result returning, what will be your personalized treatment plan for the four possible results from FNA ?

Remember, an FNA does not tell you 100% if a nodule is benign or malignant. The purpose of an FNA biopsy is to provide additional information to your physician to decide if or when a thyroid surgery may be needed. There are only four specific categories of results from a thyroid FNA and you should to know exactly what would be done with the information before the results are back. The endocrinologists at Houston Thyroid will make sure you understand every step in the process so you are clear about the long term plan for management of your nodules. Each patient will get a customized plan.

How is a thyroid nodule diagnosed?

Thyroid nodules are the most common endocrine problem in the United States. Chances are about 1 in 10 that someone in the United States will develop a thyroid nodule. Nodules are frequently detected incidentally during a physical exam by your primary care physician or by an imaging test done for another reason. Most thyroid nodules do not cause any symptoms. Once a lump is detected in your thyroid, your physician will also try to determine if the entire gland has been affected by hypothyroidism or hyperthyroidism with simple blood testing. Most people with thyroid nodules will have normal blood testing. Even though most thyroid nodules are benign, specialized testing of all thyroid nodules is required to determine which may be malignant. An ultrasound of the thyroid is the best imaging test to evaluate a thyroid nodule but it alone cannot be used to determine if a nodule is malignant.

Thyroid fine needle aspiration (FNA biopsy).

If you have a thyroid nodule, our endocrinologists , who are located in the Texas Medical Center and in Katy, are well trained to provide the proper management. Not all thyroid nodules require immediate fine needle aspiration (FNA) thyroid biopsy. If it is indicated, we will perform the procedure in our office. After the skin on top of the nodule is numbed with lidocaine, a thin needle is inserted into the nodule 2-4 times. A pressure-like sensation is commonly felt. The procedure usually takes 15-20 minutes.

The FNA biopsy provides useful information to help determine if a surgical intervention is needed to further evaluate the nodule. There are four possible outcomes from a thyroid FNA procedure. The FNA may be able to differentiate among the major types of thyroid malignancies, each of which is treated differently. The endocrinology specialists at Houston Thyroid and Endocrine provide consultation, testing, and assessment in one location on one visit.

Read our FNA risks/benefit sheet (FAQ)

How are thyroid nodules treated?

Nodules that are found to be thyroid cancer , or those that are highly suspicious for being cancerous based upon the FNA cytopathology results, are removed surgically by an experienced head and neck surgeon. If a nodule is found to be benign by fine needle aspiration, then surgery is usually not required. Instead, these nodules should be followed closely with serial ultrasound examination every 6 - 12 months for a period of time. A repeat biopsy or surgery may be needed if the nodule grows in size or begins to cause symptoms. Contact your Houston Texas endocrinologist who will be able to guide you through the many treatment options.