The Utility of BRAF Testing in the Management of Papillary Thyroid Cancer

Abstract

This review summarizes the current literature surrounding BRAF and its significance in thyroid cancer.

Comparison of the clinicopathologic features of solitary and multifocal papillary thyroid carcinoma and the utility of testing an additional tumor nodule for BRAFV600E in multifocal cases

“…Various endeavors to elucidate the origin and behavior of mPTC include both independent clonal origin of these tumors as well as intraglandular spread and subsequent clonal evolution to acquire a more aggressive phenotype [4,11,24,26]. Demonstration of the heterogeneity of BRAF V600E mutation in mPTC's also further supports the independent clonal origin of these tumors [18,26]. These varying propositions on the origin of these tumors can affect our practice of tumor nodule selection for ancillary studies which include BRAF V600E mutation.…”

“…Melck and colleagues also demonstrated that cases of PTC with BRAF V600E mutation were more likely to require cervical reoperation compared to those without mutation [18]. The overall rate of BRAF mutation in PTC has been reported up to 83% [19,20].…”

Papillary microcarcinoma of the thyroid: a review

“…It is detected in up to 83% of all papillary thyroid cancers and 30% of microPTCs [25,26]. Detection of this mutation may have a role in diagnosis, prognosis and development of management strategies for papillary cancers of the thyroid.…”

“…Detection of this mutation may have a role in diagnosis, prognosis and development of management strategies for papillary cancers of the thyroid. Studies have reported a higher incidence of adverse features such as involvement of perithyroidal tissues and nodal metastasis in BRAF mutation associated microPTCs [26]. As there is a lack of specific clinicopathologic indicators to determine which microPTCs need aggressive treatment, detection of BRAF mutation may play a role in solving this dilemma [25].…”

The BRAFT1799AMutation is not Associated with Occult Contralateral Carcinoma in Patients with Unilateral Papillary Thyroid Microcarcinoma

“…Upon postoperative pathological examination of tumor sections, 21 patients were diagnosed with multifocality of the primary tumor and among them 7 were diagnosed by using preoperative ultrasonography and 3 by using intraoperative frozen pathology techniques, indicating that multifocality of the primary tumor could not be accurately diagnosed by using preoperative or intraoperative tools. BRAF T1799A is a molecular marker of PTC and has been shown to correlate with aggressive histopathological features, including extrathyroidal extension and an increased rate of lymph node metastasis (Kebebew et al, 2007;Melck et al, 2010). Zhou et al (2012) reported that multifocality of the primary carcinoma in the unilateral lobe and BRAF T1799A mutation detected by performing a preoperative FNA biopsy could help predict the presence of occult contralateral papillary carcinoma.…”