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Test ID: THYRP Hereditary Thyroid Cancer Panel, Varies


Ordering Guidance


Customization of this panel and single gene analysis for any gene present on this panel are available. For more information see CGPH / Custom Gene Panel, Hereditary, Next-Generation Sequencing, Varies.

 

Targeted testing for familial variants (also called site-specific or known mutations testing) is available for the genes on this panel. For more information see FMTT / Familial Variant, Targeted Testing, Varies. To obtain more information about this testing option, call 800-533-1710.



Shipping Instructions


Specimen preferred to arrive within 96 hours of collection.



Specimen Required


Patient Preparation: A previous bone marrow transplant from an allogenic donor will interfere with testing. For instructions for testing patients who have received a bone marrow transplant, call 800-533-1710.

Specimen Type: Whole blood

Container/Tube:

Preferred: Lavender top (EDTA) or yellow top (ACD)

Acceptable: Any anticoagulant

Specimen Volume: 3 mL

Collection Instructions:

1. Invert several times to mix blood.

2. Send whole blood specimen in original tube. Do not aliquot.

Specimen Stability Information: Ambient (preferred) 4 days/Refrigerated

Additional Information: To ensure minimum volume and concentration of DNA is met, the preferred volume of blood must be submitted. Testing may be canceled if DNA requirements are inadequate.


Forms

1. New York Clients-Informed consent is required. Document on the request form or electronic order that a copy is on file. The following documents are available:

-Informed Consent for Genetic Testing (T576)

-Informed Consent for Genetic Testing-Spanish (T826)

2. Molecular Genetics: Inherited Cancer Syndromes Patient Information (T519)

3. If not ordering electronically, complete, print, and send a Oncology Test Request (T729) with the specimen.

Useful For

Evaluating patients with a personal or family history suggestive of a hereditary thyroid cancer syndrome

 

Establishing a diagnosis of a hereditary thyroid cancer syndrome, allowing for targeted surveillance based on associated risks

 

Identifying genetic variants associated with increased risk for thyroid and other cancers, allowing for predictive testing and appropriate screening of at-risk family members

Genetics Test Information

This test utilizes next-generation sequencing to detect single nucleotide and copy number variants in 7 genes associated with hereditary thyroid cancer syndromes: APC (including promoters 1A and 1B), DICER1, PRKAR1A, PTEN (including promoter), RET, TP53, and WRN. For more information see Method Description and Targeted Genes and Methodology Details for Hereditary Thyroid Cancer Panel.

 

Identification of a disease-causing variant may assist with diagnosis, prognosis, clinical management, familial screening, and genetic counseling for hereditary thyroid cancer syndromes.

Method Name

Sequence Capture and Targeted Next-Generation Sequencing followed by Polymerase Chain Reaction (PCR) and Sanger Sequencing.

Reporting Name

Hereditary Thyroid Cancer Panel

Specimen Type

Varies

Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Varies

Clinical Information

The lifetime risk to develop thyroid cancer is approximately 1.2%.(1) Rarely, a predisposition to thyroid cancer may be inherited in families with certain genetic alterations. Most of these genetic alterations are syndromic, meaning individuals who inherit them are usually at risk for other types of cancers or features, in addition to thyroid cancer.

 

Papillary thyroid cancers are typically sporadic but can be seen in individuals or families with familial adenomatous polyposis (FAP) syndrome, caused by variants within the APC gene (cribriform morular variant). Individuals with FAP are at also very high risk for colonic polyposis and colorectal cancer.

 

Follicular or papillary thyroid cancers may be seen in families with PTEN hamartoma tumor syndrome (PHTS). Individuals with disease-causing PTEN variants have a 70-fold increased incidence of thyroid cancer compared to the general population and are at increased risk to develop breast and endometrial cancer.(2)

 

Thyroid cancers with follicular or papillary features can also be seen in individuals with disease-causing DICER1 variants, as well as individuals with Carney complex, which is caused by disease-causing variants within the PRKAR1A gene.(3,4)

 

Approximately 25% of cases of medullary thyroid cancer (MTC) are caused by an inherited RET variant.(5) Some disease-causing RET variants are associated with only isolated, familial MTC, while others cause a syndrome called multiple endocrine neoplasia type 2 (MEN2). Individuals with MEN2 have a high risk for MTC and may also have other tumors of the endocrine/neuroendocrine system, including paragangliomas, mucosal neuromas, pheochromocytomas, and parathyroid tumors.(6)

 

The National Comprehensive Cancer Network and the American Cancer Society provide recommendations regarding the medical management of individuals with hereditary thyroid cancer syndromes.(7)

Reference Values

An interpretive report will be provided.

Interpretation

All detected variants are evaluated according to American College of Medical Genetics and Genomics recommendations.(8) Variants are classified based on known, predicted, or possible pathogenicity and reported with interpretive comments detailing their potential or known significance.

Clinical Reference

1. Surveillance Epidemiology and End Results Program: Cancer Stat Facts: Thyroid cancer. National Cancer Institute; 2018. Accessed April 25, 2024. Available at http://seer.cancer.gov/statfacts/html/thyro.html

2. Ngeow J, Mester J, Rybicki LA, Ni Y, Milas M, Eng C. Incidence and clinical characteristics of thyroid cancer in prospective series of individuals with Cowden and Cowden-like syndrome characterized by germline PTEN, SDH, or KLLN alterations. J Clin Endocrinol Metab. 2011;96(12):E2063-E2071

3. Stratakis CA, Raygada M. Carney complex. In: Adam MP, Everman DB, Mirzaa GM, et al, eds. GeneReviews [Internet]. University of Washington, Seattle; 2003. Updated September 21, 2023. Accessed April 25, 2024. Available at www.ncbi.nlm.nih.gov/books/NBK1286/

4. Schultz KAP, Stewart DR, Kamihara J, et al. DICER1 tumor predisposition. In: Adam MP, Everman DB, Mirzaa GM, et al, eds. GeneReviews [Internet]. University of Washington, Seattle; 2014. Updated April 30, 2020. Accessed April 25, 2024. Available at www.ncbi.nlm.nih.gov/books/NBK196157/

5. Shepet K, Alhefdhi A, Lai N, Mazeh H, Sippel R, Chen H. Hereditary medullary thyroid cancer: age-appropriate thyroidectomy improves disease-free survival. Ann Surg Oncol. 2013;20(5):1451-1455

6. Eng C. Multiple endocrine neoplasia type 2. In: Adam MP, Everman DB, Mirzaa GM, et al, eds. GeneReviews [Internet]. University of Washington, Seattle; 1999. Updated August 10, 2023. Accessed April 25, 2024. Available at www.ncbi.nlm.nih.gov/books/NBK1257/

7. Haddad RI, Nasr C, Bischoff L, et al. NCCN Guidelines Insights: Thyroid carcinoma, Version 2.2018. J Natl Compr Canc Netw. 2018;16(12):1429-1440

8. Richards S, Aziz N, Bale S, et al. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med. 2015;17(5):405-424

Day(s) Performed

Varies

Report Available

14 to 21 days

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

81201

81321

81406

81351

81479

81479 (if appropriate for government payers)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
THYRP Hereditary Thyroid Cancer Panel In Process

 

Result ID Test Result Name Result LOINC Value
614863 Test Description 62364-5
614864 Specimen 31208-2
614865 Source 31208-2
614866 Result Summary 50397-9
614867 Result 82939-0
614868 Interpretation 69047-9
614869 Resources 99622-3
614870 Additional Information 48767-8
614871 Method 85069-3
614872 Genes Analyzed 48018-6
614873 Disclaimer 62364-5
614874 Released By 18771-6
Mayo Clinic Laboratories | Genetics and Genomics Additional Information:

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