New technology in thyroid fine-needle aspiration

Mutations of the BRAF V600 gene in thyroid cancer were described over 10 years ago and are quite common in thyroid cancer, melanoma and adenocarcinomas, such as lung and colorectal tumours. 3 Mutation of the BRAF V600E within primary tumours of the thyroid is a highly specific indicator of thyroid cancer and most published series indicate specificity for cancer of 100%, 4 although only approximately 50% of all thyroid primary tumours show BRAF V600E mutations as mutations are confined to papillary carcinoma, or tumours which may show a papillary component, such as anaplastic carcinoma with papillary differentiation. 5 Unfortunately, routine practice frequently lags behind the available technology and while the use of BRAF V600E mutation analysis has been clearly shown to have the potential to be cost effective in reducing the need for completion thyroidectomy of the thyroid 6 7 its adoption by UK NHS has been delayed by the absence of a technology appraisal from The National Institute of Healthcare Excellence or other national guidance that recommends introduction of BRAF V600E cotesting for thyroid FNA.