Researchers have identified certain characteristics of BRAF-positive and RAS-positive thyroid cancers that may help with improving pre-operative risk assessment for suggesting a molecular profile for the disease. Sujay Kakarmath, from the division of endocrinology at Brigham and Women’s Hospital and Harvard Medical School, was part of the research team and notes, “These findings may provide guidance for clinicians as they evaluate patients with thyroid cancer, as BRAF and RAS mutations are the two most common molecular perturbations causing well-differentiated thyroid cancer.” Results of this study showed that BRAF-positive malignant nodules had worrisome sonographic features in comparison to RAS-positive nodules, which had indolent sonographic features. This may be important as clinicians are increasingly called upon to integrate molecular findings into clinical practice and deliver personalized care to their patients.
Kakarmath and colleagues studied 101 patients with well-differentiated thyroid cancer. They compared clinical, radiographic, and pathologic findings from patients with either a BRAF or RAS mutation. After sonographic evaluation of the tumors, it was discovered that RAS-positive nodules were significantly larger than BRAF-positive nodules. Additionally, BRAF-positive nodules were more likely to have concerning sonographic characteristics such as irregular margins. The researchers also noted evidence of extranodular extension in BRAF-positive nodules. While looking at fine-needle cytological findings, the research team found that 69% of BRAF-positive nodules were classified positive for papillary carcinoma, whereas 7% of RAS-positive nodules were classified positive for papillary carcinoma. Tumors positive for BRAF were also more likely to demonstrate extrathyroidal extension and lymph node metastases.
The Thyroid Care Collaborative (TCC) aims to keep physicians up to date on new research findings, ensuring that all patients are receiving the highest and most personalized level of care and achieving the best possible outcome.