In this synopsis of the early management of thyroid cancer, Caroline Kim, MD, examines the warning signs for aggressive disease in the small subset of patients who will develop recurrence after initial therapy. Applying a dynamic algorithm to define risk at every stage, Dr. Kim reviews methods to gauge response (i.e., thyroglobulin, ultrasound, cross-sectional imaging); the approach to therapy for every category of response; the application of Empiric I-131; the prognostic value of BRAFV600E in thyroid cancer and the use of systemic therapies. Includes case studies.