Figure
5: Suggestion for managemental algorithm integrating the
patient’s preference and the genetic status. In the case of lrPTMC (as
defined in the ATA guidelines) a shared decision making is required,
including a discussion between the patient and the physician, in order
to inform the patient regarding the possible strategies and explore
his/her preferred approach, which represents the utility he would assign
to each strategy. That may include evaluating factors according to
his/her perception, general medical state, and familial/social support.
If there is no clear preference for one of the strategies,BRAF V600E testing would be recommended.