In patients with differentiated thyroid cancer, do you consider pathology characteristics not found in the ATA risk stratification guidelines (ie microscopic margins or multifocal cancer) when determining recurrence risk and management?

Minimal invasive carcinoma with only capsule invasion is considered low risk. Multifocal disease with a size of more than 1 cm requires completion thyroidectomy. Overall, these factors do not appear to increase recurrence risk. Details are available at jnccn.org.