In BRAF-mutant patients, bilaterality was strongly associated with aggressive features such as larger tumor size, gross ETE, and lymph node metastasis and could serve as an independent risk factor for recurrence, corresponding to an HR of 2.23 (95% CI: 1.65,4.76; <i>p</i> = 0.020). This evidence concerns the gene BRAF and metastatic malignant neoplasm in the lymph nodes.