Thyroid Nodule Biopsy – What If My Result Is ‘Inconclusive’?

neck pain thyroid

A thyroid nodule biopsy, also known as a fine-needle aspiration (FNA) biopsy, is a standard procedure to assess thyroid nodules for cancer or other abnormalities. While many biopsy results yield clear outcomes, indicating whether the nodule is benign or malignant, there are instances where the result is labeled ‘inconclusive.’ This article delves into thyroid nodule biopsies, explores why results can be inconclusive, and discusses what steps to take if you find yourself in this situation.

Understanding Thyroid Nodules

Before diving into the complexities of inconclusive biopsy results, you must first understand what thyroid nodules are and why they are a concern. Thyroid nodules are lumps or growths within the thyroid gland, a butterfly-shaped organ in your neck, just below the Adam’s apple. These nodules are relatively common, and most are benign (non-cancerous). However, some nodules can be cancerous or harbor suspicious features requiring further investigation. According to Dr Ben Lancashire, a trusted Brisbane surgeon, thyroid nodules can be detected through physical examination, imaging studies like ultrasound, or as an incidental finding during medical tests for unrelated issues. A thyroid nodule biopsy may be recommended to determine its nature when a nodule is identified.

Inconclusive Results: Why Do They Occur?

Inconclusive biopsy results can be frustrating and anxiety-inducing for patients. When a biopsy result is labeled as ‘inconclusive’ or ‘indeterminate,’ the sample obtained does not provide a clear answer regarding the nature of the thyroid nodule. Several reasons can contribute to inconclusive results:

  • Sample Quality: The quality of the biopsy sample is crucial for accurate analysis. If the obtained sample does not contain enough tissue or is fragmented, it can make it challenging for pathologists to make a definitive diagnosis.
  • Nodule Composition: Some thyroid nodules have complex features, including cystic components or calcifications. These features can make it challenging to obtain a representative sample or interpret it accurately.
  • Cellular Atypia: In some cases, the cells within the nodule may appear abnormal but not definitively cancerous. This ‘gray area’ can lead to an inconclusive result.
  • Technical Issues: Occasionally, technical issues during the biopsy procedure or the handling of the biopsy sample can affect the results.
  • Heterogeneity: Thyroid nodules can be heterogeneous, containing a mixture of different cell types. Biopsy samples may not capture the most suspicious part of the nodule, leading to an inconclusive result.

What to Do If Your Result Is ‘Inconclusive’

Receiving an inconclusive biopsy result can be disheartening, but it’s essential to remember that it doesn’t necessarily mean cancer. However, it indicates that further evaluation or additional testing is needed for a definitive diagnosis. The first step is to discuss with your healthcare provider about the inconclusive result. They can provide you with a detailed explanation of your specific situation and guide you through the following steps. In some cases, a repeat biopsy may be recommended. A different approach, such as a core needle biopsy instead of an FNA biopsy, may yield a more conclusive result. Ensure that an experienced medical professional performs the repeat biopsy.

Molecular testing, such as gene expression profiling or molecular markers, can provide additional information about the nodule’s nature. These tests can help determine the risk of malignancy more accurately. Sometimes, if the nodule appears low-risk and is not causing symptoms, your healthcare provider may recommend ongoing monitoring with regular ultrasounds. If the nodule changes or grows, further action may be taken. 

If there are persistent concerns about the nodule’s nature, a consultation with a specialist in thyroid surgery may be recommended. They can assess whether surgical nodule removal is necessary for a definitive diagnosis. If you are unsure about the recommended course of action or would like a second opinion, don’t hesitate to consult another healthcare provider or endocrinologist specializing in thyroid conditions.


An inconclusive biopsy result for a thyroid nodule does not necessarily indicate cancer but signifies the need for further evaluation. Through consultation with your healthcare provider and potential additional testing or procedures, you can work towards obtaining a definitive diagnosis and ensuring the best possible outcome for your thyroid health.