The most common type of thyroid cancer is papillary thyroid cancer (PTC) and papillary microcarcinomas (PMC), PTC tumors of less than 1.0 cm, now account for about 40% of all PTC tumors. PMC tumors are thought to be relatively innocuous, however a PMC has an incidence of metastases of 20-50% and currently there is no ability to clearly determine if a PMC is indolent or aggressive at diagnosis. Consequently, many patients undergo surgery and may end up overtreated, increasing morbidity, while others may be undertreated, increasing morbidly from re-operation and worse outcomes.