Method: She also said that her surgeon told her he's had five patients that had a suspicious result from the Afirma test,and then when their nodules were removed and tested they too were benign! No it's actually the opposite.Many studies by different endocrinologists that were published in The American Thyroid Association's Journal in 2012 found that only 4% of the time the Afirma test falsely says cancerous nodules are benign but it falsely calls benign nodules ''suspicious'' at least 48% of the time! 2017;45:308-311. Background: A test with a better NPV (negative predictive value), would be more usefu than ever in that situation. I've read a lot about this test (both good and bad). I pointed out to them that since the nodule tested was less than 1cm the radiologist should not have sent it and they should not have tested it. I appreciate any and all responses, and please do respond, I need as much information as I can get and I live by the saying, "you don't know what you don't know." As said I have a lot of great important articles by many different endocrinologists written at different times for The American Thyroid Association's journal criticizing the Afirma test and how 48% (I'm sure it's much higher!) How they found it was my complaint of feeling tired all the time. Anyone here have a false NEGATIVE Afirma GEC result? Anyway, if these are to be become non-malignant, the rates of malignancy for the different Bethesda Categories are going to have to be adjusted downward. However, the results are not conclusive. I was doing some research and came across the Afirma Thyroid Analysis by Veracyte and was wondering if anyone in a similar situation had tried this and what there results were. ThyCa: Thyroid Cancer Survivors' Association, Inc. I was told the only way to find out for sure is to have half my thyroid removed. This large study demonstrates that almost one-half of Bethesda III/IV Afirma GSC suspicious and most Bethesda V/VI nodules had at least 1 genomic variant or fusion identified, which may optimize personalized treatment decisions. I have bumps on my head that come and go and are considered normal, and another cyst on my arm that I've had since I was eleven -- also normal. My radiologist determined that the smallest one had follicular cancer cells in her description but called it indetermined. I had the ultrasound, and am waiting for my appointment with her to go over the images. My surgeon wants to operate right away stating that these kind of results have a 90% truancy for cancer to be present. This test is performed by the company Veracyte Inc. BACKGROUND Thyroid nodules are very common, occurring in 30-50 % of patients. Now can anyone shed some light on any negative effects of RAI on your body in the long-run? Awaiting pathology. Right now my neck lymph nodes look good. Forth, I have absolutely no symptoms and feel fine. For those of you that had a thyroidectomy, how long did it take for you to realize that the medicine was or was not enough for you? Before Dincer N, Balci S, Yazgan A, Guney G, Ersoy R, Cakir B, Guler G. Cytopathology. Thank you so much! She admitted once she thinks cancer is unlikely. o The Afirma MTC testing must be billed as part of the Afirma GSC. And is this what that recent October 2015 WSJ article was hinting at.having people with certain types of cancer of the thyroid not undergo surgery at all but just adopt a wait and see posture? The overall PPV of an Afirma GSC suspicious nodule was 47%, regardless of variant/fusion status. That not only had the nodule continued to grow (from 2.0 to 3.2cm over the last 2 years), but it is now showing increased central vascularity. These gene patterns are better at ruling out thyroid cancer in an indeterminate nodule than confirming cancer. What should I know? Wong KS et al. Thanks. Thyroid cancer support group and discussion community. 1) Cytologist did not classify this as a Hurthle Cell Lesion Is it a Hurthle Cell Lesion due to predominance of Hurthle Cells? 2.) That was a hard Thanksgiving. 2020 May;162(5):634-640. doi: 10.1177/0194599820911718. Overall malignancy rates were highest in the GSC group at 39%, compared to 20% and 22% in the no-molecular-testing and GEC groups, respectively (P = 0.0222) . Thyroid fine needle aspiration biopsy: a simple procedure that is done in the doctors office to determine if a thyroid nodule is benign (non-cancerous) or cancer. Epub 2012 Oct 18. Sometimes, thyroid biopsy specimens are indeterminate, meaning that thyroid cancer cannot be definitively ruled in or out. Conclusion: Well her Afirma test result was benign,but not long after she had her thyroid removed and found she had papillary cancer that had spread into her central lymph node and she said that her surgeon told her that the Afirma test is not very reliable! Should I be treating this as a Hurthle Cell Lesion, or should I just relax. The other approach to molecular diagnosis of thyroid cancer is the measurement of oncogenes such as BRAF on FNA to make a positive diagnosis of thyroid cancer in cytologically indeterminate FNA biopsies. But, I am concerned about the report I just received. Nevertheless, I am reluctant to just proceed particularly for the following reasons: Just had TT yesterday. Comparison of Afirma GEC and GSC to Nodules Without Molecular Testing in Cytologically Indeterminate Thyroid Nodules. The results were suspicious of papillary cancer, but not conclusive. Don't want to gain weight or feel less optimal then I am now. The Afirma Genomic Sequencing Classifier (GSC) provides physicians with a comprehensive solution for a complex landscape in thyroid cancer diagnosis and individualization of care. The other tested indeterminate, follicular atypia, cannot rule out follicular neoplasm. There are 3 variants of papillary thyroid cancer: classic, follicular and tall-cell. 4. Her only information about this comes from me, as she lives across the country and can't go to doctor's visits with me. This nodule is solid, hypoechoic, increased central vascularity and now possible microcalcification. Then in December 2014 I thought to have it checked again, with the same results although this time I had it send for the Afirma testing which I was told is more accurate test for cancer. A 36% Increase in Specificity With Afirma GSC Versus Older Test . He later called and said he was sending me for a biopsy. I'd done enough research to know that Thyroid cancer is generally treatable, and was sure to tell them about that. However the "suspicious" result of the Afirma GEC does not classify these indeterminate nodules further in determining appropriate management. Patients with thyroid nodule biopsies with indeterminate cytology results were chosen for additional genetic testing; the Afirma GEC (during the period February 2, 2011July 11, 2017) or the Afirma GSC (during the period July 11, 2017December 19, 2018). I was informed in August of 2013 after a FNA that one of my nodules was suspicious and the recommendation was a TT. FOIA This all new to me and I have a lot to learn. The rate of malignancy in nodules suspicious by Afirma was 18.3% (11/60). This did not surprise me since I had researched "suspicious." Thanks. Cancer Cytopathol. Careers. Noninvasive follicular variant of papillary thyroid carcinoma and the Afirma gene-expression classifier. Ultrasound reports unfortunately not very informative other than size. What do I do? Conversely, when evaluating nodules with suspicious molecular testing, surgical rates were 88% and 89%, respectively, for GEC and GSC (P = 0.853) . She also said that her endo said that all of his colleagues stopped using this test and that in their experience the number of suspicious that came back cancerous is the same as what you find in the general population. The Afirma Genomic Sequencing Classifier (GSC) (Veracyte, San Francisco, CA) is a cancer rule-out test that partners whole transcriptome RNA sequencing with machine learning to categorize nodules as benign or suspicious. Hopefully soon afterward, I'll learn about whether or not the cells are cancerous and can begin to plan my next steps toward recovery. Epub 2021 Jun 22. He also said that what the Afirma pathologist and representatives told me that I have a 40% suspicious chance of thyroid cancer isn't true.He said it's about 25% still. -Lymph Node US: Mostly clear in neck, 1 ovoid focus in submandibular region that may be enlarged LN or Submandibular Lesion An important limitation of this study is that the authors did not examine the rate of noninvasive follicular variant papillary thyroid cancer in specimens that were not reported as suspicious by the GEC test. Epub 2017 Feb 2. Thyroid 2016;26:911-5. 5) What are your thoughts on these results? Incidental papillary thyroid carcinoma, .2 cm on Left lobe and Thyroid right lobe: 1.2 cm nodule-Papillary thyroid carcinoma, conventional and follicular variant, histologically infiltrating into adherent skeletal muscle: .2 cm and the right lobe: 1.4 cm, both Found an endocrinologist who is willing to work with me on some more testing. However, I was not informed of this. SUMMARY OF THE STUDY My doctor then sent me to an endocrinologist for a biopsy which came back with atypical but inconclusive results. The mindset of medical doctors is to analyze the information at hand and see if anything changes that warrants getting more data or doing surgery.". But still my labs are all within normal range. The Afirma Genomic Sequencing Classifier (GSC) result was "Suspicious," but the usual orange color (representing ~50% risk of malignancy) of this result is replaced with gray, foreshadowing that . With these genetic tests, patients and physicians have more information to feel confident about avoiding surgery or pursuing it based on the test results. The https:// ensures that you are connecting to the http://www.thyroidboards.com/showthread.php? Thyroid cancer is found in ~5% of thyroid nodules, so the vast majority are benign (noncancerous). Noninvasive Follicular Variant of Papillary Thyroid Carcinoma and the Afirma Gene-Expression Classifier. Can someone give me their take on my fna results? Of the 16 cases of follicular variant papillary thyroid cancer, 14 of them were noninvasive follicular variant of papillary thyroid cancer (88%). Here member santef1 says she had a 2cm nodule that came as suspicious from the Afirma test but after surgery that nodule was found to be benign but as with what happened to so many people,they found several micro pap cancers not seen on the ultrasound. A publication of the American Thyroid Association, Summaries for the Public from recent articles in Clinical Thyroidology, Table of Contents | PDF File for Saving and Printing, THYROID CANCER Repeat Fine Needle Aspiration Cytology Refines the Selection of Thyroid Nodules for Afirma Gene Expression Classifier Testing. The Afirma GSC is a next-generation genomic test that relies on RNA sequencing and advanced machine learning methodology to categorize tissue from cytologically indeterminate FNA biopsy as either benign or suspicious.2 I opted for a total after much thought because I had three un biopsied nodules on the other side and was already hypo with my entire thyroid to begin with. The biopsy (Afirma) was indeterminate with GSC suspicious with a 50% ROM. Genes hold the information to build and maintain an organisms cells and pass genetic traits to offspring. Fingers crossed they come back negative for cancer! The PPV was 50% among GSC suspicious nodules when a variant or fusions was identified, compared with 44% among GSC suspicious nodules when no variant or fusion was identified (p = 0.77 [2]). See Somatic Mutation Testing - Solid Tumors guideline for criteria. Two have been tested by FNA multiple times over 5 years National Library of Medicine In this discussion of the Afirma test from 2013 on this board several people also had false results from the Afirma test all false suspicious except for the first, reply from member dacooper12 who said that the Afirma test said her nodule was benign but later she had her thyroid removed and found out that it was actually pap cancer that spread into her central lymph node. All thyroid nodules with a "suspicious" Afirma GEC result were investigated. Adherence to Active Surveillance and Clinical Outcomes in Patients with Indeterminate Thyroid Nodules Not Referred for Thyroidectomy. Also is anybody here familiar with "Afirma Thyroid Analysis" But, she ordered another ultrasound because she wants to see the images herself, rather than just rely on reports from the radiologist. The Afirma MTC may not be billed separately using an additional unit or procedure code. Background: The Afirma Gene Expression Classifier (GEC) has been used to further characterize cytologically indeterminate (cyto-I) thyroid nodules into either benign or suspicious categories. Second, this nodule has been stable and has not grown from the first day it was discovered. (The office had already explained that benign results would be sent in a letter, but suspicious or confirmed cancer results would warrant a phone call.) Of course I could have gotten very lucky and caught a cancer in it's early stages, but as well, I do not want to remove a healthy organ . If you have benign results they always wonder. And it keeps growing. Another problem with Afirma is that pretty soon they are going to have to adjust the test to the reclassification of non-invasive FVPTC. So when I say the doctor's says suspicious for cancer with a 75% possibility, I'm not sure how she gets 'unlikely' from that. I'm fearful this is a Hurthle Cell Lesion, and I do not like what I have read. Baca SC, Wong KS, Strickland KC, Heller HT, Kim MI, Barletta JA, Cibas ES, Krane JF, Marqusee E, Angell TE. Currently, gene tests can provide more information as to whether an indeterminate nodule is a cancer or not. I was told that my thyroid needs to be removed (at least half, possibly all). 2021 Aug;31(8):1253-1263. doi: 10.1089/thy.2020.0969. A publication of the American Thyroid Association, Suspicious readings of the Afirma gene-expression classifier include some noninvasive encapsulated follicular variant of papillary thyroid carcinomas. The GSC correctly identified 41 of 45 malignant samples as suspicious, yielding a sensitivity of 91.1%, and 99 of 145 . In this study from Boston, 63 thyroid surgical specimens were reviewed from patients whose thyroid biopsy samples were read as indeterminate and in whom the GEC test was reported as suspicious. The .gov means its official. eCollection 2021. Most probably, a lot more lobectomies are going to be performed for indeterminate nodules since the level of certainty is going to drop. One of these women member dacooper12 on Inspire in their ThyCa forum had the opposite result,which the studies show,that the Afirma test misclassifies a much smaller % of cancerous nodules as benign compared to the higher % of benign nodules it misclassifies as "suspicious. Our new findings show that the real-world experience supports this data, further demonstrating that the likelihood of malignancy in Afirma GSC-suspicious nodules is even greater than what was . Qualifiers of atypia in the cytologic diagnosis of thyroid nodules are associated with different Afirma gene expression classifier results and clinical outcomes. I am wondering if anybody can comment on whether my case described below is considered to be reclassified according to the recently released guidelines.
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