Doctor refused Fine Needle Aspiration as likely to give a false positive result, should I be concerned?

[BeeOrchids]

Hi, I went for a booked Fine Needle Aspiration yesterday following an ultrasound which found two lumps on my thyroid gland. Both are less than 1 centimetre and were classed as U3 which I understand means FNA is the best way of assessing them. I had mentioned when booking the appointment that I have needle phobia and if possible could I have a local anaesthetic i.e. gel put on my neck before the procedure. In the event I was very calm for the appointment (thanks to advice given in another thread). The doctor was aware of the needle issue and said if I didn't want the FNA she did not have to carry it out. We then had a discussion about the fineness of the needle and that a local anaesthetic injection would use a needle of the same degree of fineness. I replied that I understood the need for having the FNA done and that I was keen for the doctor to proceed if necessary.

The doctor then said that she had looked at the previous ultrasound results taken and didn't feel she needed to do a FNA as it was likely to show a false positive result. I was told this is very common in smaller lumps and nodules. I have Googled today and see that a false positive is recorded in between 2-10% of results. I don't think that shows as being particularly common.

An ultrasound was then carried out and the doctor showed me on a screen the results, two lumps which were quite clear on the ultrasound done. She said I have Thyroiditis and the gland is very inflamed from it, I am Hyperthyroid with Graves diagnosed last year. The lump I can feel and see slightly in my neck (which is on the opposite side from the ones being checked) and the sore throat and cough I have had constantly for over a month were dismissed as most likely something else. She has said I will have another ultrasound in a years time and not to worry because thyroid lumps are very slow growing.

I have a follow up appointment with the ENT department next week and think they will discharge me. I felt the doctor didn't want to have to deal with a nervous patient yesterday and have a fear she will say I refused to have the FNA. Should I be concerned about this?

Sorry this is so long.

[humanbean]

I felt the doctor didn't want to have to deal with a nervous patient yesterday and have a fear she will say I refused to have the FNA. Should I be concerned about this?

If the doctor's report is dishonest then yes you should be concerned and you should make sure the record is corrected. Once a patient has been described as "non-compliant" (i.e. you didn't do what the doctor said) it has a knock-on effect on future treatments for anything, and makes it harder than it already is to get taken seriously.

[BeeOrchids in reply to humanbean]

Thank you, that's really helpful. I will be very clear next week that I was happy for the FNA to take place as planned

[BeeOrchids]

I should add I have pain swallowing and told the ENT specialist that I have not been able to eat easily for the last few weeks because of this

[tattybogle]

i'm my own experience of some pretty unpleasant cancer tests ,(and that of my OH who worked in hospital) if they have concerns , or significant doubt about cancer that is potentially urgent, they will find a way to do <<whatever procedure>> anyway , even on a very nervous patient .. NHS are very used to dealing with nervous patients (even downright abusive / non compliant ones) every other day . So honestly, i really seriously doubt that the only reason it wasn't done was that you were likely to be any more 'difficult' to handle than the next patient.

By the sounds of what they said to you at the previous 'nose camera' appointment . the FNB was not a dead cert anyway .. it was to be at least partly decided based on another look at the scan results .

So i would try not to get yourself in a state thinking they may have missed something just because you let them know you were very nervous.

But obviously you want re-assurance on this matter . so i would mention your concern at the next appointment, and hopefully they will be able to explain better why they didn't feel it was necessary to do it at this point.

[BeeOrchids in reply to tattybogle]

Thank you, was so relieved yesterday at a 'No Needle Day' and it wasn't until this morning I started to be concerned. I will certainly mention next week that I have felt worried since the appointment.

I have been very lucky up until now and not needed many tests done on me so find it all a bit overwhelming

[Brightness14]

After a lump was found on my thyroid I was given a FNA it proved negative, that was in November 2014 in the UK. In June 2015 I was back in France and had my thyroid removedthe lump was found to have papillary cancer, so perhaps you doctor is right.

[BeeOrchids in reply to Brightness14]

Thank you for replying to me. The Doctor I am sure knew what she was doing. They don't carry out FNA for fun so I have to be guided by them.

[serenfach]

I have had two done - they just froze the site with a sort of liquid as I do not react to local anaethetic. The first came back negative but the doctor who did it did not trust the result so did another one. I was so worried that I would not get home as it was snowing outside and I had to drive over a mountain that the actual needle did not worry me!

The second proved negative too. Really, plucking out a nose hair hurts more. Honest.

I would express your concerns and maybe ask for an MRI which will show any changes in the lumps to set your (and their) minds at rest.

[BeeOrchids in reply to serenfach]

I will have a chat to the specialist next week. They have all been incredibly kind and nice to me at every appointment I have had. I find they are happy to answer my questions and explain what things mean so see what they say