BRAFV600E Mutation is a Strong Preoperative Indicator for Predicting Malignancy in Thyroid Nodule Patients with Atypia of Undetermined Significance Identified by Fine Needle Aspiration

Choi, Hye Rang; Choi, Boyoon; Cho, Jae Hoon; Lim, Young Chang

doi:10.3342/kjorl-hns.2018.00199

Cited by 1 publication

(1 citation statement)

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“…Use of molecular markers in AUS is limited only to self-paying patients as contrasted to other parts of the world wherein NRAS, HRAS, TERT gene, and BRAF V600E gene mutations are utilized in some cases of AUS, and once detected, malignancy risk is strong (22). In contrast, BRAF V600E gene mutation is typically encountered in aspirates of thyroid papillary carcinoma and cases of suspicious for papillary carcinoma and rarely in AUS and suspicious for follicular neoplasm (23).…”

Section: Discussionmentioning

confidence: 99%

Clinical management of thyroid aspirates diagnosed as atypia of undetermined significance in the Philippines

Abelardo¹,

Sotalbo²

2020

Gland Surg

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Although the cytologic criteria of atypia of undetermined significance (AUS) are defined in The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), there is heterogeneity in its prevalence, utilization, interpretation, and management. To determine the current practices of physicians of various specialties in the management of thyroid lesions reported as AUS in fine-needle aspirates in the Philippines, a survey consisting of eighteen questions was sent to physicians of varied specialties. Survey questions included geographical location of practice, type of practice (whether in a private or government setting or with academic affiliation), annual patient load, primary operator of fine-needle aspiration (FNA), number of procedures performed, method used, whether by palpation or with ultrasound-guidance, preprocedure requirements, request for rapid on-site evaluation (ROSE), awareness and utilization of thyroid image reporting and data system (TI-RADS), knowledge of cytologic preparation of aspirates, utilization of TBSRTC nomenclature in the workplace, number of AUS that turned out benign, number of AUS that turned out malignant, management of AUS cases in the setting of patient and physician, utilization of frozen section, implication of surgery over repeat FNA. There were seventy four respondents composed of 20 (27%) otorhinolaryngologists, 15 (20%) pathologists, 14 (19%) endocrinologists, 13 (18%) radiologists, and 12 (16%) general surgeons, practicing in different institutions, with majority (58%) of the respondents based in the National Capital Region. AUS report was encountered by 58 respondents (78%) in up to 10% of their cases, eight respondents (11%) had AUS report in up to 20% of their cases and only one respondent (1%) had AUS report in more than 30% of the cases. Seven (10%), who were mainly radiologists, did not answer the question. Thirty nine physicians (53%) conservatized management with medical follow up and repeat FNA within the time frame prescribed in the Bethesda system, 11 (15%) referred patients with AUS for surgery, 16 (22%) had varied comments. Eight (11%) respondents, who were mainly radiologists, did not answer the question. The data shows that the approach to management of AUS is heterogenous amongst physician-specialists, although, majority of clinicians adhere to the practice guidelines of the American Thyroid Association. Deviation to the guidelines occur since approach to management of patients is individualized.

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Section: Discussionmentioning

confidence: 99%