BRAF mutation and age in differentiated thyroid cancer risk stratification: Two sides of the same coin.

BRAF V600E mutation is seen in about 45% of patients with Papillary Thyroid Carcinoma (PTC). Thyroid cancers are among the unique cancers where the age influences the prognosis. Current evidence suggests BRAF mutation in the presence of other risk factors in DTC is associated with poor prognosis. Considering the high prevalence of the BRAF mutation in differentiated thyroid cancer, there has been an inclination to include molecular testing as a rule-in test. However, studies have shown a reciprocal relationship between BRAF mutations and advancing age. One needs to rethink if both are two independent poor prognostic indicators. The future risk stratification systems should use technological advances to create a truly dynamic system that incorporates molecular markers in cohesion with age.