Presence of gene mutation helps guide thyroid cancer...( A specific gene mutation may be usef...)

A specific gene mutation may be useful in predicting the level of aggression of thyroid cancer and help guide treatment options and follow-up care, according to new study findings.

The mutation, called BRAF V600E, is a genetic alteration in the BRAF oncogene, a modified gene believed to cause cancer. The new research is reported in the September issue of the Annals of Surgery.

Past studies have shown that the mutation frequently occurs in the most common type of thyroid cancer, conventional papillary thyroid cancer or PTC, but this is the largest study to classify thyroid cancer by cell structure subtype and to show that the mutation is significantly associated with cancer recurrence after treatment, according to the research team.

The findings come at an important time as both the incidence of thyroid cancer and the number of patients who die from the disease is increasing in the United States. More than 33,000 new cases of thyroid cancer are expected to be diagnosed in 2007, according to the National Cancer Institute.

Most patients diagnosed with thyroid cancer have small, localized PTC but may receive aggressive treatment because their risk of recurrence and death cannot be reliably predicted prior to surgery, the study authors noted.

There is a pressing need to identify a reliable preoperative approach for stratifying patients according to risk of thyroid cancer recurrence and death, said lead author Electron Kebebew, MD, who is an assistant professor of surgery and endocrine surgeon at the University of California, San Francisco and a research scientist with the UCSF Comprehensive Cancer Center.

This study shows that a particular mutation is a reliable indicator, and testing for the mutation may be useful for selecting initial therapy, determining the need for and extent of surgery, as well as the need for ongoing monitoring and follow-up care, he emphasized.

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