The Bethesda System for Reporting Thyroid Cytopathology explained for practitioners: Frequently Asked Questions

The recent update of the Bethesda system for reporting thyroid cytology (TBSRTC) is a very important development in the evaluation of thyroid nodules. Clinical experience and scientific literature both show that practitioners performing thyroid FNA are accustomed to basing the clinical management of patients on reports using TBSRTC. Specifically, clinicians are familiar with the per cent risk of malignancy (ROM) corresponding to each TBSRTC diagnostic category (DC), as well as with the respective recommendation for clinical management. However, most clinicians are much less familiar with the specific considerations that lie between a specific DC, on the one end, and the respective ROM and associated management recommendation, on the other end. A deeper understanding of the system can enlighten the clinician’s thinking about the specific nodule under examination and can guide the decision-making process in a more meaningful way. Such an understanding can only be developed via close, two-way communication b...