It also depends on the experience of the pathologist, analyzing the sample, and using US to get a good sample. If not, they can do a direct biopsy, but a FNAB is preferred per NCCN guidelines, which does not interfere with any future surgeries like a direct biopsy can or run the risks associated with surgeries, but either can be done. I had 7, at three different cancer centers, two that are top, and all sent me for a FNAB, and were accurate.
