We are pleased to introduce this focused issue of Gland Surgery on the “Cancer Risk Stratification and Management of Indeterminate Thyroid Nodules”.
During the last decade, thyroid cancer has become the most commonly diagnosed endocrine malignancy in the world (1,2). The rapid expansion of thyroid ultrasound use, both for diagnosis and for screening has uncovered a reservoir of thyroid disease, contributing to a thyroid cancer “epidemic” (3). This leads to an increasing number of fine needle aspirations (FNA), with approximately 25% of all thyroid biopsies not rendering a definitive cytological diagnosis. Based on the current diagnostic approach, half of all resected thyroid nodules have a pre-operative indeterminate cytology and 75% of them prove to be benign after diagnostic surgery. This ongoing overtreatment exposes our patients to short- and long-term surgical complications, and many will face the need for lifelong thyroid hormone replacement. Therefore, the management of indeterminate thyroid nodules is of great importance.