RAI ABLATION WITH BRAF+ 1.2CM NODE-NEGATIVE PAPILLARY CANCER?

RAI ABLATION WITH BRAF+ 1.2CM NODE-NEGATIVE PAPILLARY CANCER? 22Jan2013
QUESTION- your opinion on this patient please. 34 yo anesthesiologist noted a midline thyroid nodule 1 month ago, no hx of irradiation to head and neck. us revealed a 1.2 cm hypoechoic nodule at jx of isthmus and right lobe, fna highly suspicious for mjalignancy, 2nd opinion dr sebo at mayo same, total thyroidectomy and central neck dissection pt1b n0 follicular variant papillary cancer 1.2 cm. braf v 600 e positive. would this genetic mutation influence you to suggest ablative I131 therapy.
SJ Rosenbloom, PhD, SJ Rosenbloom PhD, MD
RESPONSE – No, but perhaps for a different reason. Personally, I believe the patient’s post- treatment course is improved significantly by low-dose 1311-I ablation, with a lack of a downside. Having a negative neck scan, negative US, and negative TG are comforting . Being BRAF+ is an additional positive for ablation, but I would do it anyway. L De Groot, MD

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