The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) was introduced in thyroid fine needle aspiration cytology (FNAC) in 2010. A six-tier system is generally accepted.
Bethesda categories include morphologic description, risk of malignancy and follow-up suggestions in each group. The system has its advantages and disadvantages, that are discussed.
The most problematic are the categories of „Atypia of undetermined significance“ or „Follicular lesion of undetermined significance“ (AUS/FLUS). The group is heterogenous and overused thus far.
The possibilities of its improvement are discussed. The Bethesda system does not include any prognostic and predictive markers.
However, they represent the promising direction in the improved version of the BSRTC. Novel molecular methods and alternative techniques such as core needle biopsy are briefly discussed.