Fine needle aspiration biopsy results in thyroid nodules comparison of ultrasonography findings and postoperative pathology results in cases reported as bethesda III-IV

Thyroid nodules are common pathologies. Although most of the thyroid nodules don't give clinical findings, about 90% of the nodules are benign. What is important in the evaluation of thyroid nodules is to recognize thyroid cancer, which will affect the patient's health if left untreated, and to avoid overdiagnosis. Ultrasonography is the first imaging modality to be ordered when thyroid nodules are suspected and to determine the characteristics of the nodules. The sonographic features of the nodule allow clinicians to infer the risk of thyroid cancer. Fine needle aspiration biopsy is performed for cytologic examination of suspicious nodules. The treatment method is determined according to the cytologic result. Various systems have been developed to universally express sonographic features and cytologic examination results in a common language. The 'American College of Radiology Thyroid Imaging, Reporting and Data System' for imaging and the 'Bethesda System for Thyroid Cytopathology Reporting' for cytologic examination are widely used. In our study, we retrospectively analyzed patients who were classified as indeterminate according to the Bethesda system and underwent diagnostic thyroidectomy. Postoperative histopathologic rates were compared. The contribution of nodule size and the American College of Radiology Thyroid Imaging, Reporting and Data System for the diagnosis of thyroid cancer in the indeterminate groups was questioned. Thyroid nodule size alone was not helpful in diagnosing cancer. Although the American College of Radiology Thyroid Imaging, Reporting and Data System contributed to clinical decision-making, it was concluded that it did not make a statistically significant difference. Recent developments have led to the use of molecular tests for patients in the uncertain group. The only barrier to the feasibility of molecular testing is considered to be its cost. Invasive diagnostic methods used in thyroid cancer diagnosis can lead to complications. The development of standardization systems and the widespread use of molecular tests should aim to reduce unnecessary interventional procedures.