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Thyroid Cancer: Molecular Testing

Molecular testing in thyroid nodules is becoming more commonplace. New studies are coming out regularly on its indications and benefits.

What is Molecular Testing?

Molecular testing is used to get a better understanding of a thyroid nodule. Molecular testing involves analyzing the DNA and RNA of the thyroid nodule to ascertain information about genetic abnormalities, gene mutations, gene fusions in addition to other metrics that lead to the nodule’s development which also contribute to its future potential. At ENT Specialty Group the following molecular tests are performed: ThyroseqV3, Afirma GSC and ThyGeNEXT/ThyraMIR.

Why is Molecular Testing Performed?

The information obtained from molecular testing often helps thyroid specialists personalize management and may help to determine the optimal management for your thyroid nodule or thyroid cancer. Molecular tests are often used to determine whether the likelihood of malignancy of an indeterminate thyroid nodule is high or low. When molecular testing of an indeterminate thyroid nodule returns as negative, surgery is often avoided. When a molecular test is positive for thyroid cancer, surgery is often advised. Molecular testing can also help determine whether the likelihood that a thyroid malignancy is aggressive is increased or not. Molecular testing can also help with the treatment plan for aggressive thyroid cancers. This includes the extent of surgery, in addition to the management of aggressive thyroid cancers with a specifically “matched” targeted form of chemotherapy in the rare instances that it is needed.

How is Molecular Testing Performed?

An ultrasound is used to identify the nodule. A small needle is then introduced in the nodule to obtain the sample. It does not take very long. It is similar to the procedure that is performed for a traditional biopsy of the thyroid. Depending on the type of molecular test that is being done (ThyroseqV3, Afirma GSC or ThyGeNEXT/ThyraMIR), the specimen is analyzed using different methods including next generation DNA and RNA sequencing for genetic abnormalities, gene mutations, gene fusions and other anomalies.