Dr.Guttler’s Thyroid Patient Blog Post: When is Molecular Testing in Class III or IV nodules needed? Almost always!

DR.Guttler’s Comments:

The study results were that Cytology and Ultrasound were not able alone or together able to separate the benign for the cancer nodules without molecular testing except in  small group of Class IV nodules with high degree of a significant association by ultrasound with thyroid cancer.

However, 85% of the Class II and IV nodules 53/62 would benefit with molecular testing.

The patient with a class III or IV that does not have high risk TiRAD 5 ultrasound needs molecular testing before allowing the surgeon to remove your thyroid.

Any thyroid surgery causes quality of life issues for the rest of your life.Even after lobectomy there is significant risk of needing thyroid hormone replacement for life.

Call me for a pre-surgery consult to be sure it is needed.

Benign nodules are best treated by minimally invasive radiofrequency ablation RFA.

No quality of life issues, no need for hospital surgery, or thyroid hormone.

Low complication rates and after 30-45 minute procedure in my office, you can go home and continue your life.

310-393-8860 or email to thyroid.manager@thyroid.com

Dr.G.

Arch of Endocrinology Sept 2021

G.Pena et al

1. 62 patients studied all had a thyroidectomy

2. 32/62 had thyroid cancer at surgery.

3.30/62 had benign nodules.

4. Class III atypia was associated with benign nodules.

5. Only Class IV with Ti-RADS 5 was associate with cancer at surgery.

6. High risk by Class IV and Ti-RADS 5 was able to define high risk of cancer.

7. However 85% 53/62 of Class III and IV nodules would benefit in molecular testing.