Factors Influencing the Decision on Surgery or Observation for Patients with Bethesda Category 3 (AUS/FLUS)

Excerpt

The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) proposes a repeated fine-needle aspiration (FNA) for nodules with atypia of undetermined significance or a follicular lesion of undetermined significance (AUS/FLUS) on the initial FNA.1 Cibas and Ali1 reported that to increase the diagnostic accuracy of the AUS/FLUS FNA category and to prevent unnecessary surgery, two approaches have been proposed. The recommended management is clinical correlation and a repeated FNA at an appropriate interval.1 ^– 3 In some cases, the physician may choose not to repeat the FNA but to observe the nodule clinically or, alternatively, to refer the patient for surgery because of concerning clinical and/or sonographic features.1 Thus, determination of sonographic features associated for surgery or observation is important. …