Thyroid Nodules ≥4 cm: Can Ultrasound and Cytology Reliably Exclude Cancer? Reply

Excerpt

We thank Dr. Rosário for his comments on our recent study “Thyroid Nodules ≥4 cm: Can Ultrasound and Cytology Reliably Exclude Cancer?” [1], which was an updated and follow-up study to the work of McCoy et al. [2]. In thyroid nodule evaluation, we completely agree that ultrasound characterization and cytological analysis of fine-needle aspiration biopsy (FNAB) specimens remain the gold standard diagnostic modalities to exclude malignancy, and both have been shown in a number of studies to be accurate predictors of thyroid cancer [3‐5]. We have reported in our two studies that even in thyroid nodules ≥4 cm, if either suspicious ultrasound features were present or FNAB was positive for malignancy, histologic malignancy was highly likely and we have not abandoned these very informative preoperative tests. …