ArticleJournal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale2021
Rate of malignancy for thyroid nodules with AUS/FLUS cytopathology in a tertiary care center - a retrospective cohort study.
Article in Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnostic Accuracy of Fine-Needle Biopsy in the Detection of Thyroid Malignancy: A Systematic Review and Meta-analysis.JAMA surgery · 2022Pooled it
- An Evaluation of Immature Granulocytes as Predictors of Malignancy in Patients with Atypia of Undetermined Significance Thyroid Nodules.Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme · 2026Article
- Prevalence and predictors of malignancy in Bethesda III and IV thyroid nodules undergoing surgery.Frontiers in endocrinology · 2026Article
- Surgical outcomes of Bethesda System for Reporting Thyroid Cytopathology diagnostic category class I, II, and III thyroid nodules.Frontiers in endocrinology · 2026Article
- Evaluation of the Necessity of Repeat Biopsy in Patients with Thyroid Nodules Classified as Atypia of Undetermined Significance (AUS) Based on Fine-Needle Aspiration Biopsy Results.Medicina (Kaunas, Lithuania) · 2025Article
- Proposal for Clinical Management of Nodules Diagnosed as Atypia of Undetermined Significance via Thyroid Fine-Needle Aspiration Cytology in the Absence of Molecular Testing.Cytopathology : official journal of the British Society for Clinical Cytology · 2025Article
- Clinico-cytopathological subcategorization in thyroid nodules of atypia of undetermined significance/follicular lesion of undetermined significance using the TIRADS and Bethesda classifications.Frontiers in endocrinology · 2023Article
- Optimization of the Management of Category III Thyroid Nodules Using Repeat FNA and TIRADS.Cancers · 2022Article
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6 authors.
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Abstract
backgroundThyroid nodules are stratified through fine-needle aspiration (FNA) and are often categorized using The Bethesda System for Reporting Thyroid Cytopathology, which estimates the risk of malignancy for six cytopathological categories. The atypia of undetermined significance (AUS) and follicular lesion of undetermined significance (FLUS) categories have varying malignancy rates reported in the literature which can range from 6 to 72.9%. Due to this heterogeneity, we assessed the malignancy rate and effectiveness of repeat FNA (rFNA) for AUS/FLUS thyroid cytopathology at our institution.
methodsElectronic health records of patients with AUS/FLUS thyroid cytopathology on FNA at our center since the implementation of the Bethesda System on May 1, 2014-December 31, 2019 were retrospectively reviewed. Patient demographics, treatment pathway, and pathology results were collected. The treatment pathway of the nodules, the rFNA results, and the malignant histopathology results were reported. Malignancy rates were calculated as an upper and lower limit estimate.
resultsThis study described 182 AUS/FLUS thyroid nodules from 177 patients. In total, 24 thyroid nodules were deemed malignant upon histopathology, yielding a final malignancy rate of 13.2-25.3%. All of the malignancies were variants of papillary thyroid carcinoma. The malignancy rate of the nodules which underwent resection without rFNA (21.5%) was lower than the malignancy rate of the nodules which underwent resection after rFNA (43.8%). 45.5% of the rFNA results were re-classified into more definitive categories.
conclusionThe malignancy rate of AUS/FLUS thyroid cytopathology at our center is in line with the risk of malignancy stated by the 2017 Bethesda System. However, our malignancy rate is lower than some other Canadian centers and approximately half of our rFNAs were re-classified, highlighting the importance of establishing center-specific malignancy and rFNA re-classification rates to guide treatment decisions.
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