2021 Volume 60 Issue 3 Pages 187-191
The Bethesda System for Reporting Thyroid Cytopathology was revised according to the new proposal to include thyroid border-line lesions in the WHO Histological Classification of Thyroid Tumours (2017). This proposal was made with objective of allowing unnecessary surgeries to be avoided in thyroid cancer patients. In the United States, every patient with a malignant cytodiagnosis is generally advised to undergo total thyroidectomy and additional postoperative radiotherapy. However, unnecessary surgeries are avoided in Japan, because several treatment choices are available for the treatment of thyroid cancer. Therefore, Japanese medical associations concerned with thyroid surgery and pathology have not accepted this newly proposed category of border-line lesions, and have also refused to accept the explanatory note for border-line lesions provided in the revised Bethesda System. We believe that the basic principle of diagnosis and treatment is a discussion about what would be the best policy in daily medical practice.
