In Reply.
—Miller and his colleagues are recognized for their leadership and experience in fine-needle aspiration of thyroid nodules. Their percentage cancer index of 55% is impressive and is one of the highest published as shown in the figure cited in our article.1(p475)The referral of most patients with solitary thyroid nodules from community hospitals to a "needle biopsy team" may be unnecessary or may entail considerable inconvenience and expense. Some patients may want surgical excision of the nodule for cosmetic reasons. Some patients refuse to leave the familiar environment of their communities. We would predict that more community physicians will become skillful in the needle aspiration technique itself as data to establish its worth continues to accumulate. The aspirate2 or slides could be sent to an appropriate outside pathologist if sufficient local expertise was not available.