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Please provide information and how much it hurts-for fine needle biopsy

hopeful girl 1
Posts: 454
Joined: May 2010

Everyone,

Please share information regarding fine needle biopsies? I have been reading some scarey accounts online and I am really nervous as I think I am going to need one possibly due to thyroid nodules.

I read needle is supposed to be very small, yet one poster noted it felt more like a knitting needle.

Yikes.

Thank you.

nasher
Posts: 507
Joined: Apr 2010

the worst it felt like to me was a cross between getting a tattoo and a blood draw but on my neck

sunnyaz
Posts: 582
Joined: Oct 2010

Very small needle. Not what I consider painful, but I have been through childbirth. See my other post for more information.
Julie-SunnyAZ

hopeful girl 1
Posts: 454
Joined: May 2010

Thank you for your feedback.

I feel alittle bit better after reading your posts.

What kind of doctor is it that I would be referred to? An endocrinologist?

Where did you both have the FNA done? Was it done in an ultrasound room? Did you have the shots to numb the area? Did you have the topical numbing agent? Did you have any sedative? How long did it take?

Did you have any pain/swelling in the neck afterwards? Did you have many nodules? I am not sure how many nodules as so far I just received a copy of part of summary.

What does it mean if the thyroid is enlarged? Could this be from my chemos that I had for the uterine cancer? When I had chemo from the first chemo it always seemed to bother my glands. My oncologist said that was unusual.

What would be reasons they would need to remove thyroid if it is not cancerous?

That is scarey to think the FNA can come back non-cancerous and upon surgery the finding can still be cancerous.

Cindy

lynn2318
Posts: 41
Joined: Jan 2010

I had a fine needle aspiration biopsy that was inconclusive. The endocrinologist that did it wanted to wait 6 months then repeat it. My internist said that was not good enough and sent me to a surgeon who looked at my I131 uptake and scan and said the thyroid needed to be removed since the scan looked suspicious. I had stage IV papillary thyroid carcinoma, which means it spread to the lymph nodes. If I had waited 6 months things could have been worse. I am 2 1/2 years post surgery. I have had 2 RAI treatments and still have a measurable tumor marker. I hope this info is helpful. I don't mean to scare you but maybe they need to answer a few questions before you have the biopsy. Keep us posted.

alapah's picture
alapah
Posts: 262
Joined: Oct 2009

Mine was done by an Endocrinologist in an ultrasound place. I think I had a lidocaine injection first. They used the ultrasound to guide the needle. It was unpleasant but not overly painful. I think that if you are really nervous they might be able to prescribe an anti-anxiety med ahead of time but you likely would not need that. I had one nodule but it was rather large as nodules go so I had a number of needles used during the FNA. My neck was a bit sore for a few days but nothing aspirin could not handle. If I remember correctly, there was only one insertion point through which the doc angled the various needles, one at a time.

Thyroids can be enlarged due to endocrine issues that aren't necessarily related to cancer. Sometimes they remove part of a thyroid if there is a suspicious nodule so they can do the pathology. Best to remove it and know than to wait if the nodule is of a certain size or has suspicious characteristics, so I have been told. I had a total thyroidectomy myself. Even if it's inconclusive at the time of the FNA and found to be cancerous at surgery, at least you'd be on your way to the pathway to treatment. Papillary thyroid cancer is very treatable. Then again, perhaps the FNA will be clearly non-cancerous or surgery will confirm it is non-cancerous if the FNA comes back inconclusive. My advice is one step at a time. Try not to get ahead of yourself too much with the "what ifs".
Best to you.

hopeful girl 1
Posts: 454
Joined: May 2010

Perhaps I will be advised to have a scan.
I am guessing that I will have to be sent to an Endocrinologist by my gyno surgeon/oncologist. He is the one that ordered the ultrasound, as during the summer when I started chemo, the incidental of the thyroid nodules showed up on an ultrasound. He said we would wait til I finished my chemo to look at it further.

Yes, I guess one step at a time is what I need to remember....

I am scared to think I could need surgery......I had two major surgeries, end of March and end of April for my uterine cancer-which was major major surgery and I had 6 chemos and 25 radiations this year. My immune system is still recovering, and my bloodcounts are still working their way back up after chemo. So I don't feel my body is super strong to have another surgery.

sunnyaz
Posts: 582
Joined: Oct 2010

Hi Cindy,

One of my FNA's were done at my ENT's office. The other two were done at the hospital with Ultrasound guidance. You could be referred to both an ENT and and Endocrinologist. If at all possible try to get in with someone who is a Specialist in Endocrinology/Oncology that is also a surgeon. I have one here in Tucson at the University of Arizona Cancer Center. My ENT wasn't the right choice after the first surgery, (the Thyroidectomy) because they usually aren't real knowledgeable about how cancer spreads. He did a wonderful job on the Thyroidectomy but the Lymphectomy was a different story. He went into the wrong sections of the neck and while he found three out of thirty four nodes with cancer, he should have gone to the first section (6) to get the original node that was spotted on the US, biopsied and targeted for removal. He missed it, causing more spread a third surgery with second RAI to come. He did not know that if there was cancer is sections three, four and five that there had to be cancer in six as well.

I had no pain or swelling after any of my FNA's. The last one he had to go in about four times to get to the right areas and then did a Thyrogen wash. I asked my doctor to prescribe some Diazapam 5mg (Valium) to take before my procedures and they really helped to calm me down. I had someone drive me to and from. The Thyroid can be enlarged for so many reasons and yes, it could be from the chemo.

The reasons to remove the Thyroid if it is not cancerous is if it is causing you difficulty in breathing or swallowing. If the nodules become large and embarrassing for you or it simply decided to stop working. In which case you can talk with your new doctor for advise on that. It does happen that the biopsies come back negative time and time again with normal TSH counts and there is still cancer. My TSH levels were always completely normal which is why my Primary Care Doctor did nothing about it until I insisted.

Julie-SunnyAZ

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