64: Managing Indeterminate Thyroid Nodules, with Dr. Kimberly Vanderveen from Denver Center for Endocrine Surgery
Kimberly Vanderveen, MD is a Colorado native and graduate of Bear Creek High School in Lakewood, CO. She received her bachelor’s degree with honors from Muhlenberg College in Allentown, PA. She then earned her medical degree from Northwestern University in Chicago, IL in 2001.
In this episode, the following topics are discussed:
* Two roads of tests: rule out and malignant markers
* Rule-out tests picks up innocent behavior pattern. Most common is Afirma
* Malignant markers, or rule-in tests, are useful at determining extent of surgery, and help avoid a second or third surgery. ThyroSeq, ThyraMIR, Rosetta
* Do patients get both tests? Rule out and behavior?
* Approximately 15% of FNA’s come back indeterminate. Some centers as high as 30%
* Managing indeterminate nodules when a patient chooses no surgery.
* Taking into account emotional, financial, and lifestyle goals of the patient.