Molecular Testing in Thyroid Cancer

Molecular testing looks for specific genetic changes in thyroid cells (from FNAC samples) to help predict whether a nodule is benign or cancerous, especially when cytology is unclear.

It is most useful for indeterminate nodules (Bethesda III and IV), where FNAC alone cannot confidently say if the nodule is cancer.

• It can help avoid unnecessary surgery if the gene profile suggests a benign pattern.
• Alternatively, if mutations linked to cancer are found, it guides the surgeon to plan the right extent of surgery.

Yes. In poorly differentiated and anaplastic thyroid cancers, molecular testing identifies mutations such as BRAF, RAS, RET, NTRK, ALK, TP53, etc.

They help guide:

• Targeted therapy options (e.g., BRAF inhibitors, RET/NTRK inhibitors)
• Prognosis and treatment planning
• Enrolment in advanced treatment protocols

No. Most patients with classic papillary thyroid cancer do not need routine molecular testing. It is mainly used when the diagnosis is uncertain or when cancers behave aggressively.

Yes. It is done on the same FNAC sample or tissue biopsy—no additional invasive procedure is usually required.