Molecular Testing of Thyroid Nodules: Distinguishing Misuse from Appropriate Use

Excerpt

Diagnostic surgery or repeat biopsy is currently indicated for the ~25 % of nodules with fine-needle aspiration biopsy results that are cytologically indeterminate [i.e., classified according to the Bethesda System for Reporting Thyroid Cytopathology as atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), follicular neoplasm or suspicious for follicular neoplasm, or suspicious for malignancy].1 The dual goals of preoperative evaluation are to limit unnecessary thyroid surgery and perform the correct procedure in one initial step, if possible. Using molecular profiling as a diagnostic adjunct to improve risk stratification of cytologically indeterminate thyroid nodules has been the topic of active investigation. Studying the clinical effectiveness of integrating molecular tests into practice is much needed and was the focus of the article by Han et al., “The Impact of Molecular Testing on the Surgical Management of Patients with Thyroid Nodules.” …