79: No Biopsy is 100% Accurate⎥Molecular Testing Gets Close, with Dr. Bridget Brady from Austin Thyroid Surgeons

Molecular testing can reduce unnecessary thyroid surgeries by 50% or more

Dr. Bridget Brady

is Austin’s first fellowship?trained endocrine surgeon. She has a passion for and expertise in disease of the thyroid, parathyroid, and adrenal glands. Since completing her endocrine surgery fellowship in 2006 under Matthias Rothmund, MD, an internationally acclaimed endocrine surgeon, she has performed thousands of thyroidectomies and parathyroidectomies here in Austin. Dr. Brady focuses on a variety of minimally invasive techniques to optimize patients’ medical and cosmetic outcomes. Her fellowship training in Germany and experience in Austin have enabled her to specialize in patients with recurrent or persistent disease of the thyroid and parathyroid, including thyroid cancer. She offers complete diagnostic workups including in-office ultrasounds and FNA biopsies of thyroid nodules and lymph nodes.
Dr. Brady was named director of endocrine surgery for the new medical school in Austin. She was also recently chosen to teach general surgeons seeking additional training in endocrine surgery. Dr. Brady instructs these endocrine surgeons from the Baylor Scott and White fellowship program.

In this episode the following topics are discussed:

  • Dr. Brady sees 30 patients per week for thyroid nodules
  • Up to 80% of US population could have a thyroid nodule(s)
  • 10% of Dr. Brady’s thyroid nodule patients test positive for cancer
  • How relevant is what I don’t know won’t hurt me in thyroid cancer and biopsies of nodules?
  • BETHESDA system or the middle category, also known as indeterminate
  • For thyroid nodules that are indeterminate, historically a surgery would be performed
  • With molecular testing, surgery can be decreased by up to 50%
  • Afirma molecular testing uses messenger RNA
  • If Afima comes back suspicious it does not mean cancer
  • Insurance covers molecular testing
  • Nest steps for a doctor who would like to incorporate molecular testing
  • Suspicious usually means benign
  • How do you calmly tell a patient they have cancer?

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NOTES

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