Surgical implications of B-RafV600E mutation in fine-needle aspiration of thyroid nodules.
BACKGROUND
Management of patients with thyroid nodules is based on establishing an accurate diagnosis; however, differentiating benign from malignant lesions preoperatively is not always possible using current cytological techniques. Novel molecular testing on cytological material could lead to clearer treatment algorithms. B-Raf(V600E) mutation is the most common genetic alteration in thyroid cancer, specifically found in papillary thyroid cancer (PTC), and usually reported to be associated with aggressive disease.


METHODS
A literature search using PubMed identified all the pertinent literature on the identification and utilization of the B-Raf(V600E) mutation in thyroid cancer.


CONCLUSIONS
The utility of using B-Raf mutation testing for nodules with indeterminate cytology is limited since many of those nodules (benign and malignant) do not harbor B-Raf mutations. However, when the pathologist sees cytological features suspicious for PTC, B-Raf(V600E) mutation analysis may enhance the assessment of preoperative risks for PTC, directing a more aggressive initial surgical management when appropriate.
Mekel
Michal
M
Thyroid Cancer Research Laboratory, Endocrine Surgery Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Nucera
Carmelo
C
Hodin
Richard A
RA
Parangi
Sareh
S
D044963:Biopsy, Fine-Needle; D004252:DNA Mutational Analysis; D006801:Humans; D009154:Mutation; D018579:Patient Selection; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*; D016606:Thyroid Nodule / Q000235:genetics* / Q000473:pathology* / Q000601:surgery
C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf