ASSESSING THE NEED FOR FROZEN-SECTIONS - STILL A VALUABLE TOOL IN THYROID-SURGERY

Background. Since the development of fine-needle aspiration (FNA) ther e has been a trend away from frozen sections (FS) in the assessment of thyroid neoplasms. The objective of this study was to determine the r ole of FS in the surgical management of thyroid nodules in the presenc e of an adequate FNA biopsy finding. Methods. Charts of patients who p resented within a 3-year period for thyroid surgery were reviewed. Inc lusion criteria consisted of both an adequate FNA and FS. Results. Eig hty-five patients met the inclusion criteria. Three lesions were benig n, 71 were suspicious, and 11 were malignant with FNA. There were 66 d eferred and 19 malignant diagnoses with FS. The overall accuracy for F NA and FS was 40% and 86%, respectively. When the FNA report was posit ive for malignancy, is was correct in 91% (10 of 11) of the cases. Whe n the FNA report was suspicious, only 30% (21 of 71) had a malignant l esion. FS confirmed malignancy in 19 patients and deferred more extens ive surgery in 66 patients with suspicious lesions. However, 18% of th e deferred FS were found to be malignant on final pathology report. Co nclusions. This study showed that there is a role for FS in the surgic al management of thyroid nodules. Frozen sections can be useful when, the FNA report is suspicious for malignancy; however, FS may be elimin ated when the FNA report is positive for malignancy.