Julie A. Sosa, MD, MS, professor of surgery and medicine, chief of endocrine surgery, Duke University, discusses molecular testing for thyroid cancer.
One of the most contentious issues in thyroid cancer is the utilization and interpretation of molecular testing and markers, Sosa believes. This field is rapidly evolving, which creates a challenge for clinicians to stay up to date.
At the ATA Annual Meeting, Sosa gave a presentation on the utilization of molecular testing for patients who have indeterminate thyroid nodules, which occurs in about 30% of all biopsies preformed in the United States. The main challenge for physicians is knowing when to use molecular testing and how to interpret the results. To aid in this process, it is important to know the unique institutional incidence of thyroid cancer for each of the Bethesda indeterminate categories, Sosa notes.
At this point, there is not a perfect test for detecting cancer in indeterminate nodules, placing importance on taking history, physical examination, ultrasonographic characteristics, and a second opinion to help determine the status of the nodule. Patients must also be counseled about the risks and benefits of molecular testing, since they are the critical decision maker, Sosa notes.
New ATA guidelines on molecular testing and differentiated thyroid cancer are expected to be released early next year.
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