Please click on this link below about the woman with a 1-1 and half cm solid hypoechoic nodule who had an inconclusive Fine Needle biopsy which was suspicious as a follicular neoplasm and mine is being called a follicular neoplasm with oncocytic (hurthle cell features) ,this woman had her FNA nodule sample tested by the veractye Afirma Test which is what I had done,the results came back telling her that her that their results on her FNA was highly suspicious and that because of this her endo told her she had an 80% chance of having thyroid cancer and so she had her thyroid out and found out it was benign! The original Afirma gene test was a gene expression classifier (GEC) that used a technology called a microarray that results in a pattern of gene expression. I'm curious, if you had similar biopsy results and had surgery, was your final path malignant or not? This study suggests that more research is needed to determine if the noninvasive follicular variant thyroid cancer can be diagnosed by molecular markers without proceeding to surgery. Independent Comparison of the Afirma Genomic Sequencing - PubMed Many endocrinologists have written articles in The American Thyroid Association's journal criticizing the inaccuracies and unrelabilities of this recent Afirma test, the strongest criticism and concern is by endocrinologist of (*50* years!) 2020 May;162(5):634-640. doi: 10.1177/0194599820911718. I'm looking for any and all help and/information you can share with me. Wow! Results: Afirma result was suspicious in 69 cases. After hearing this, I felt a huge kick in my gut and also stupid for getting a second opinion for a fine needle biopsy though I'd ended up with an endo, who wrote articles on the subject. I hope this helps calm some fears for others who may be going through the same thing. -FNAB Result: Predominantly Hurthle Cells, Abundant Macrophages, Colloid and Bloody Background: Bethesda 3 (FLUS/AUS) But, I am concerned about the report I just received. It's really upsetting to suddenly be thrust into this with no symptoms, etc. Have lots of decisions to make and just trying to do some homework. My Enfo bumped up my Synthroid right away to adjust for the surgery. However, its relatively low positive predictive value (PPV) limited its use as a classifier for patients with suspicious results. the nodule was only 1.5 cm and I really had no concerning symptoms. HHS Vulnerability Disclosure, Help government site. Suspicious readings of the Afirma gene-expression classifier include some noninvasive encapsulated follicular variant of papillary thyroid carcinomas. 2017 May;125(5):313-322. doi: 10.1002/cncy.21827. After reading many stories, I didn't know what to expect. The aim of this study was to determine the clinical performance of the GSC as compared with the GEC at one academic medical center. Genes hold the information to build and maintain an organisms cells and pass genetic traits to offspring. There are risks and benefits to any decision - and humans are very bad at assessing both. The overall PPV of an Afirma GSC suspicious nodule was 47%, regardless of variant/fusion status. But still my labs are all within normal range. 2.) So frustrating!! They were incredibly supportive and also concerned. I have also read a recent 2015 report that posits that there are built-in subjectivities to begin with at the Ultrasound/Pathology level yielding "Indeterminate" or "Atypical Cells" to begin with that then sets up a natural path to getting a "Suspicious" result from Afirma. I didn't want to live with the risk, especially already being hypo and having nodules on the other side slowly growing. So, in 2014, Thanksgiving was about telling them there was something going on. Thyroid nodules are commonly found on ultrasound of the neck and the evaluation of a thyroid nodule may include thyroid biopsy. They billed my insurance $6684 - my ins negotiatied $3370.40 they have billed me for 883.71, I applied for a reduction but they say I make too much income so I am not eligible for one. Any help really will be appreciated. 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. 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. Thyroid nodule molecular profiling: The clinical utility of Afirma Papillary Thyroid Cancer: the most common type of thyroid cancer. So, I found a new endo, whom I absolutely loved at my first appointment. The Afirma Xpression Atlas for thyroid nodules and thyroid cancer 2021 Oct 7;5(11):bvab148. 1. This process has helped me to realize that there is a lot that physicians do not understand--much more than I knew. Finally, the cells were sent to Afirma, Now I was growing concerned. 85% were benign. 5) What are your thoughts on these results? 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. Some people say I should have had my thyroid out years ago. 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? PDF Lab Management Guidelines V1.0.2020 Afirma Thyroid Cancer - eviCore Thoughts or experiences?? One > 4cm, but has tested benign by FNA 4 times I also recently found *another* article written by an endocrine surgeon Sam Wiseman from the Department of Surgery ,St.Paul's Hospital University Of British Columbia for the site Gland Surgery where he also points out real concerns that half of patients(as I said I know it's more,from all of the people I have found posting on thyroid boards) with benign nodules wrongly classified as "suspicious" by the Afirma test are getting unnecessary thyroid surgery because this Afirma result influenced a lot of endocrinologists and their patients to have the thyroid surgery!
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