Issue: May 2011
May 01, 2011
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Large-needle aspiration biopsy of thyroid not more painful than fine-needle aspiration

Issue: May 2011
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American Association of Clinical Endocrinologists 20th Annual Meeting

SAN DIEGO — Based on a survey of self-reported pain of patients, large-needle aspiration biopsy appears to be no more painful than fine-needle aspiration.

Angelo Carpi, MD, of the University Hospital of Pisa and Pisa University, Italy, and colleagues compared pain among two groups of patients: those who had fine-needle aspiration only (n=79; 87% women; mean age, 59 years) and those who had fine-needle and large-needle aspiration (n=41; 90% women; mean age, 60 years).

Patients were asked at each successive visit whether he or she experienced:

  • no unpleasant feeling/sensation;
  • unpleasant sensation;
  • mild pain (no analgesic used); or
  • pain (analgesic used)

The patient responses indicated a pain score of 1 in both groups, based on a score of 0 to 3.

Large-needle aspiration biopsy is a demonstrated safe and useful technique for physicians to preoperatively select indeterminate follicular nodules and nodules inadequate at fine-needle aspiration biopsy. However, some patients perceive large-needle aspiration as more painful than fine-needle aspiration because of the larger nodules used (18- to 20-gauge vs. 22- to 25-gauge), Carpi et al wrote in their study.

“It should be considered to extend the clinical use of large-needle aspiration biopsy also because, compared to fine-needle aspiration biopsy, it provides a much better substrate for thyroid tumor marker determination,” the researchers concluded. “These data confirm our long-standing experience that large-needle aspiration biopsy is not more painful than fine-needle aspiration biopsy.”

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