A quick, minimally invasive outpatient test that uses a thin needle to sample cells from a thyroid nodule — determining if it's benign or malignant in under 20 minutes.
BY DR. RAJEEV PREMNATH GENERAL & LAPAROSCOPIC SURGEON, BANGALORE
Takes less than 20 minutes, usually requires no anaesthesia or just a local numbing agent
Uses a thin needle finer than a standard blood-draw needle to sample cells from the nodule
Patients return home immediately, most without even needing a band-aid
"The test is far less uncomfortable than patients expect, and the cytology report typically settles 70 to 80 percent of cases without needing surgery at all." — Dr. Rajeev Premnath
The entire procedure wraps up in 10 to 15 minutes. Patients remain seated throughout, and the needle is finer than a standard blood-draw needle. If a nodule is flagged TI-RADS 3 or higher on ultrasound, FNAC is the next step before anyone discusses thyroid surgery.
Patient lies flat with a small pillow under the shoulders so the neck tilts back and the thyroid pushes forward where the needle can reach it cleanly
A 23 to 27 gauge needle goes in under live ultrasound view, two to four passes, each one pulling cells from a slightly different part of the lump for better yield
Antiseptic over the skin — that's the only prep.
No sedation, no general anaesthesia, sometimes not even a local because the needle is that fine
Fluid gets smeared onto glass slides right there in the room, fixed quickly and sent off, where a cytopathologist reads them under microscope
Results come back using the Bethesda System — six categories that determine next steps. Most reports land in Bethesda II (Benign), roughly 60 to 70 percent of cases, meaning the nodule isn't cancerous and a follow-up scan in 12 to 24 months is the only ask.
Roughly 60 to 70 percent of reports land here. A follow-up scan in 12 to 24 months is the only ask — no surgery needed.
Cells look slightly off but not clearly malignant. A repeat FNAC, molecular testing, or surgical evaluation figures out whether a diagnostic lobectomy makes sense.
Bethesda V means a 60 to 75 percent chance of cancer; surgery usually goes ahead without waiting. Bethesda VI confirms thyroid cancer outright, and total thyroidectomy, sometimes with neck dissection, becomes the plan.
Most patients walk out without needing a band-aid. A bit of soreness for a few hours and maybe a small bruise — that's about it.
Day care thyroid surgery has changed how disruptive the whole process feels — patients can go home the same day.
• Cytology results ready in 2 to 5 working days
• No pain medication needed for most patients
• Day care thyroid surgery available if needed
Suspicious thyroid nodules picked up on ultrasound, especially ones bigger than 1 cm with worrying features.
About the same as a routine blood draw — most patients get through it without any pain medication.
Ultrasound-guided FNAC has 95 to 97 percent accuracy, though rare false negatives can happen with very small or cystic nodules.
WHY CHOOSE DR. RAJEEV PREMNATH?
20+ Years of Experience
General and Laparoscopic
Surgeon heading Day Care
Surgery at Ramakrishna
Specialty Hospital
International Training
Minimal access surgery training in France and Singapore — same precision applied to thyroid evaluation
No rush toward the operating room. Surgery only recommended when cytology genuinely calls for it.
Most thyroid nodules are benign — and FNAC can give you clarity quickly, often without the need for surgery. Dr. Rajeev Premnath explains your report clearly and recommends surgery only when the cytology genuinely calls for it.
Consult with Dr. Rajeev Premnath, General & Laparoscopic Surgeon, Bangalore
References
National Cancer Institute — Thyroid Nodule Cytology & Diagnosis; NCBI — The Bethesda System for Reporting Thyroid Cytopathology