The efficiency of performing ultrasound-guided fine-needle aspiration biopsy following mass screening for thyroid tumors to avoid unnecessary surgery

Thyroid masses are a common clinical finding, and their management remains controversial. The purpose of this study was to evaluate the clinical effec t of performing routine ultrasound (US) examinations and US-guided fine-nee dle aspiration biopsy (US-FNAB) in the management of diffuse or nodular goi ter diagnosed by mass screening, Mass screening carried out from 1993 to 19 96 revealed 444 women with goiter, 322 of whom had diffuse goiter and 122 h ad nodular goiter. All of these patients underwent US examination, the resu lts of which determined that 169 should undergo US-FNAB to confirm an accur ate diagnosis of their thyroid tumors. Histological examinations after surg ical resection revealed that 12 of the 322 patients with diffuse goiter (3. 7%) and 23 of the 122 with nodular goiter (18.9%) had malignant tumors. Amo ng the 61 thyroid tumors surgically verified, US-FNAB yielded a sensitivity rate of 93%, a specificity rate of 81%, and an accuracy rate of 90%. Insuf ficient aspiration was obtained from 5%. Performing US-FNAB-resulted in an elevation in the percentage of malignant tumors yielded at surgery of up to 72%. Thus, ultrasonography followed by US-guided-FNAB could be a useful ro utine method of evaluating thyroid tumors detected by mass screening. Moreo ver, a greater number of unnecessary thyroid operations can be avoided by p erforming US-FNAB rather than FNAB alone.