Thyroid biopsies and the importance of a second pathological review.
Two women contacted me recently about their daughters, who both had thyroid nodules removed. Both daughters were told they might have thyroid cancer, but the biopsies were questionable. I said it was very important for the biopsies to be reviewed by a pathologist in a big medical center who had considerable experience with thyroid tissue. One daughter's surgeon told her it was important that she have the whole thyroid removed right away. That did not make sense and I hoped the mother would urge her daughter to get a second opinion. The daughter was frightened by what the small town surgeon said and went ahead with the surgery. She now is paying a price for that because she has no idea if she had cancer or not.
Many small hospital pathologists try to be experts on all kinds of biopsies, but medicine has become too complicated for one pathologist to be have had experience with every kind of tissue. I found that out when I looked at muscle biopsies from all over the U.S. Many pathologists just signed out the biopsies to go along with the admitting diagnosis, when some of them were unreadable.
I have not heard if the other daughter got a second opinion. She lives in a state that is well known for poor medical care, so I hope she used better judgment than the first daughter. I remember when my husband had a biopsy of a thyroid and I looked at the biopsy with a wonderful pathologist. I was directing a muscle program in a big university hospital and learned a great deal about how surgeons and pathologists worked. So a second opinion is always wise, particularly when there is a question.