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 . and I said this is not a good test,and he said I don't think it's a good test either! We conclude that cytology interpretation has a higher rate of predicting malignancy, in nodules interpreted as SN, when compared with the Afirma test, by almost twofold Diagn. The aim of this study was to find out how often indeterminate thyroid biopsy specimens which were read as suspicious by the GEC test were ultimately diagnosed as noninvasive follicular variant papillary thyroid cancer after surgery. Please enable it to take advantage of the complete set of features! Follicular Neoplasm. But it is saying that actual surgical results show that 40% "suspicion" turns out to send lots of people to surgery and then about 50% of the surgeries done yield results that show that the nodules were not cancerous at all. Accessibility My expensive, unsolicited, Afirma test results came back as negativegood thing I had already had my TT before I received the results; I have stage III pap/follicular thyca. So, if you were going to go down that route then this will save you from having a second biopsy. 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. 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. 5. Thyroid. Genes hold the information to build and maintain an organisms cells and pass genetic traits to offspring. I wasn't one to resist. PMC Afirma BRAF V600E o Afirma BRAF testing may be considered for either GSC or FNA suspicious or malignant results. The results of the GEC are either read as suspicious for cancer or benign. I had another biopsy which came back showing "Atypical cells". Papillary thyroid cancer is the most common type of thyroid cancer. It seems like with every ultrasound, some new suspicious characteristic pops up. 3) What do I need to know? All my blood tests and tsh levels are in the normal range. Will find out results in about a week. Neither will talk to the other. Genes hold the information to build and maintain an organisms cells and pass genetic traits to offspring. My blood tests came back totally normal and I am totally asymptomatic. I don't think the reclassification was mentioned specifically in the WSJ article. 2. Still, I can see my nodule on one side and don't want to risk having cancer in my body, so I was ready to set up the surgery as soon as possible. No parathyroid tissue identified. Results: Afirma result was suspicious in 69 cases. Second, this nodule has been stable and has not grown from the first day it was discovered. Long-Term Outcomes of Thyroid Nodule AFIRMA GEC Testing and Literature Review: An Institutional Experience. The moment that I've been so nervous about finally came yesterday. Paratracheal nodule (inclduing B1FS): Thyroid Parenchyma, negative for tumor. But, I'm also tired of living with the uncertainty and semi-annual nerve sessions after each ultrasound. Others understand my need for more information. Afirma said NEGATIVE for BRAF and Meduliary but still assigned a classification of "Suspicious" with 40% chance of cancer. Thyroid bloodwork normal. This isn't saying that Afirma's test isn't useful. Also difficult is the reaction from others. and transmitted securely. Wong KS et al. Historically, most patients with indeterminate thyroid nodule biopsies were referred for surgery though most would ultimately not have thyroid cancer (around 75% or more would have an unnecessary surgery). Thyroid Nodules: http://www.thyroid.org/thyroid-nodules/, Thyroid Cancer: http://www.thyroid.org/thyroid-cancer/, Thyroid Surgery: http://www.thyroid.org/thyroid-surgery/. Epub 2012 Oct 18. 2020 May;162(5):634-640. doi: 10.1177/0194599820911718. So the jump from that mentality to that of, "oh, I can get cancer, too" has big a huge one for me. -5.5cm x 3.9cm x 3.9cm Left Thyroid Nodule: Large mixed/mostly solid, isoechoic, ill-defined margins, macrocalcifications, taller-than-wide: TI-RADS 5 Silaghi CA, Lozovanu V, Georgescu CE, Georgescu RD, Susman S, Nsui BA, Dobrean A, Silaghi H. Front Endocrinol (Lausanne). They call follicular neoplasms with hurthle cells FNOF. The Afirma GSC is a cancer rule-out test with a high negative predictive value so that cytologically indeter-minate (Bethesda III/IV)2 thyroid nodules with an Afirma GSC benign result can be considered for clinical observation in lieu of diagnostic surgical resection (Fig. 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. WHAT ARE THE IMPLICATIONS OF THIS STUDY? My thyroid nodule (1.5 cm) was discovered by mistake; the technician was only supposed to do an ultrasound on my gallbladder and ovaries, but for some reason did my thyroid as well. The Afirma test results came back Benign on left side and Suspicious 40% on the right side . See Somatic Mutation Testing - Solid Tumors guideline for criteria. Found an endocrinologist who is willing to work with me on some more testing. Only when I had a follow up visit with a cardiologist in JAn.of 2016 he noticed the results after requesting the previous scan results. The Afirma gene expression classifier (GEC) is being increasingly utilized to confirm the benign nature of indeterminate FNA cytology results thus avoiding unnecessary surgical procedures. Can you expand on this? The Afirma Genomic Sequencing Classifier (GSC) was developed and clinically validated to utilize genomic material obtained during the FNA to accurately identify benign nodules among those deemed cytologically indeterminate so that diagnostic surgery can be avoided. Endo M et al 2019 Afirma Gene Sequencing Classifier compared with Gene Expression Classifier in indeterminate thyroid nodules. 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. Patient medical records were retrospectively reviewed for clinical history, FNA results, radiologic findings, management and follow-up. I hadn't told my two college-age daughters about the series of more and more concerning doctor's visits, but knew I couldn't get through a long day with them at home without showing my emotions. Gorshtein A, Slutzky-Shraga I, Robenshtok E, Benbassat C, Hirsch D. Eur Thyroid J. 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 NODULES They were incredibly supportive and also concerned. 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. How they found it was my complaint of feeling tired all the time. Baca SC, Wong KS, Strickland KC, Heller HT, Kim MI, Barletta JA, Cibas ES, Krane JF, Marqusee E, Angell TE. Therefore, a new version of the Afirma test was created called a gene sequencing classifier (GSC) to better predict thyroid cancers in indeterminate nodule while still being able to rule out cancer in benign nodules. the GSC is to further differentiate indeterminate FNA. SUMMARY OF THE STUDIES Thyroseq However the "suspicious" result of the Afirma GEC does not classify these indeterminate nodules further in determining appropriate management. - Partial was recommended at first, though we are leaning total now with the remainder of tests now complete. BTW, I'm about to turn 50 and I have no thyroid issues other than this. 2020 Sep;8(9):e1288. Now can anyone shed some light on any negative effects of RAI on your body in the long-run? I heard about the Afirma analysis , spent $5000 on the test and the results are even more confusing !! I was informed in August of 2013 after a FNA that one of my nodules was suspicious and the recommendation was a TT. 1. Third, I have no history of thyroid cancer (or any cancer) in my family. I'm looking for any and all help and/information you can share with me. But in my case, it was a risk well worth taking. This did not surprise me since I had researched "suspicious." The Afirma MTC may not be billed separately using an additional unit or procedure code. My Afirma results came back suspicious. My surgeon wants to operate right away stating that these kind of results have a 90% truancy for cancer to be present. I understand that Afirma tends to have a lot of false positives, but it's supposed to be fairly accurate for negative results. Cancer-Associated Genes: these are genes that are normally expressed in cells. t=5283[/url]. I knew it was not good news. No one was telling me that. And the 3rd test was Afirma which came back "suspicious". 2021 Apr;10(2):168-173. doi: 10.1159/000509037. So I thought I was in the clear, and decided to just monitor this nodule for growth, and revisit the surgery idea only if size became an issue. Unable to load your collection due to an error, Unable to load your delegates due to an error. One such test is the Afirma gene test. I have multiple nodules. Thyroid 2016;26:911-5. 3. She says very little, and if she does say anything, questions my reactions. Disclaimer. I'm a foodie who has always struggled with weight, but I also exercise so I'm always just plump but in otherwise decent health. 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. I wanted to share my Thyroidectomy story because like most of you I was super scared and nervous about surgery but my surgery went great and I've had no complications. Adherence to Active Surveillance and Clinical Outcomes in Patients with Indeterminate Thyroid Nodules Not Referred for Thyroidectomy. 2021 Aug;31(8):1253-1263. doi: 10.1089/thy.2020.0969. Polavarapu P, Fingeret A, Yuil-Valdes A, Olson D, Patel A, Shivaswamy V, Matthias TD, Goldner W. J Endocr Soc. So now I feel I have no choice to take it out (the nodule also grew .5 cm since the Aug test). Bethesda, MD 20894, Web Policies 2021 May 13;12:649522. doi: 10.3389/fendo.2021.649522. Thanks again, Ok so this is all brand new to me so please bear with me. I don't trust this new Afirma thyroid test for very good reasons. I posted the below post on this forum on several different topics since 2013. The original Afirma Xpression Atlas (XA) panel reported on 761 genomic variants and 130 fusion pairs from 511 genes ( 6 ). They did not address that issue in their letter, just my income. So, in 2014, Thanksgiving was about telling them there was something going on. Home Patients Portal Clinical Thyroidology for the Public February 2020 Vol 13 Issue 2 p.13-14, CLINICAL THYROIDOLOGY FOR THE PUBLIC I had that one sent to Afirma, and it came back indeterminate on cytopathology again, benign on GEC. My surgeon and endocrinologist said no further treatment is needed but to continue observation. I didn't take the nodule too seriously, but did see a specialist and also got the FNA. I called my husband before I even received the callback, and couldn't stop crying. Anyone have AUS nodule with suspicious Afirma results end up cancerous? Multiple nodules. So frustrating!! Unauthorized use of these marks is strictly prohibited. Suspicious Nodule Surgery the Only Option? The Annual International Thyroid Cancer Survivors' Conference and Regional Workshops, Download our free Low-Iodine Cookbook (PDF), Rally for Research and Thyroid Cancer Research Grants. 85% were benign. The rest were called benign by the GEC. http://www.glandsurgery.org/article/view/1002/1193, http://biotechstrategyblog.com/2012/06/veracyte-, Papillary and follicular thyroid cancer (differentiated), Multiple endocrine neoplasia type 2 (MEN2), Mental challenges of living with thyroid cancer, ThyCa fundraising and thyroid cancer research grants. Careers. Any Insights? Current analysis of thyroid biopsy results cannot differentiate between follicular or hurthle cell cancer from noncancerous adenomas. And he said he doesn't think the Afirma test is as accurate as they say. The other side is that I had to have a 2nd biopsy done just to collect cells for AFIRMA. Here are some results/Info: 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. I really hope that a much better,much more accurate reliable test like this will be created! Wong KS, Angell TE, Strickland KC, Alexander EK, Cibas ES, Krane JF, Barletta JA. I'm a lumpy person, I told my husband. The pathology report on the removed nodule said: Molecular markers can be used in thyroid biopsy specimens to either to diagnose cancer or to determine that the nodule is benign. Epub 2020 Aug 6. Which if they used the YTD income they could clearly see that I qualified for a reduced billing. Have lots of decisions to make and just trying to do some homework. The results were suspicious of papillary cancer, but not conclusive. Indeterminate Thyroid Biopsy: this happens a few atypical cells are seen but not enough to be abnormal (atypia of unknown significance (AUS) or follicular lesion of unknown significance (FLUS)) or when the diagnosis is a follicular or hurthle cell lesion. Results: Thirty-eight TP53 variants were present among >13,000 Bethesda III/IV Afirma GSC Suspicious samples. Among the 22 with only a TP53 alteration, the first 16 consecutive nodules were included (7 nodules were Bethesda III and 9 nodules were Bethesda IV). 1). I was told to monitor my nodules every couple years using ultra-sound and if they increased in size, they needed to have FNA done. I had numerous FNA biospy's last result "suspicious for follicular neoplasm " , the last ultrasound showed several microcalcifications on left and scattered microcalcification on the right. I had a total thyroidectomy in NYC. 2018 Jul;126(7):471-480. doi: 10.1002/cncy.21993. The aim of this study was to determine the clinical performance of the GSC as compared with the GEC at one academic medical center. While most thyroid nodules are non-cancerous (Benign), ~5% are cancerous. Each of my pre-surgical tests are pointing more and more in the wrong direction. Thyroid nodule biopsies are used to identify if a nodule is cancerous or determine the risk that a thyroid nodule may be cancerous. This site needs JavaScript to work properly. Finally, at the endocrinologist's visit, he told me the results came back as suspicious for papillary cancer on both sides, and that I'd need to have a TT. I scheduled the surgery for June 3rd but now I'm apprehensive because I don't want to have surgery if there's a chance of this to be benign. B. He recently called me back and said that my criticism of the test is valid. I'm now 3 days post op and other than some difficulty swallowing and talking loud, I'm feeling great. 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. I don't understand the results , I thought that if the result is Benign it means you have no cancer genes and it is 95% sure you won't get cancer . Would you like email updates of new search results? Afirma was suspicious. The remaining 18% were malignant. However, I was not informed of this. Personally, I think getting the AFIRMA test done is a good thing. 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! May 7 endocrinologist Dr.Bryan Mclver,one of the authors of the article from September 2012 in The American Thyroid Association's Journal called,An Independent Study Of A Gene Expression Classifier (Afirma) In The Evaluation Of Cytologically Indeterminate Thyroid Nodules Initial Report and he used to work at The Mayo Clinic,(he now works at The Moffit Cancer Center called me back. I am scheduled to have a TT on March 9th and I wish I felt a little better about my decision. Advice needed please. In early September, at a well-woman visit, my primary care doctor found a lump in my neck and sent me for a sonogram that found three nodules -- one estimated at 3.5 cm, one at 1.5 cm and the third much smaller. She didn't seem overly concerned based on all my previous records. I think my biggest problem is what I read on the internet as far as all the problems afterwards. Tumor is partially encapsulated with no capsular invasion or extrathyroidal extension identified. http://onlinelibrary.wiley.com/doi/10.1002/cncy.21455/full. The Affirma Xpression Atlas is based on RNA sequencing. A total of 27 patients with GEC benign nodules had surgery for nodule growth or patient preference and 3 had a papillary thyroid microcarcinoma discovered at final pathology while the rest were benign. Here's what a friend of mine wrote who is a retired neurologist: "They can both be right for different reasons, or from different perspectives. 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. These results show an improved accuracy for the GSC as compared with the GEC. This nodule is solid, hypoechoic, increased central vascularity and now possible microcalcification. [url=http://www.thyroidboards.com/showthread.php? for my adopted daughter as she's already lost her bio-parents and thus my husband and I became her new parents.I've stayed like zombie while awaited my total neck ultrasound results and they came back CLEAR any cancer spreading to lymph nodes..yey! It's pretty difficult being the patient trying to sort this all out. Papillary thyroid carcinoma, Follicular Variant, 2.1 cm in greatest dimension, present in mid to lowe pole, woth prior FNA site changes. I know, that is still pricey but seems cheap compared to $6,000. At least 1 genomic alteration was identified by the expanded Afirma XA panel in 70% of medullary thyroid carcinoma classifier-positive FNAs, 44% of Bethesda III or IV Afirma GSC suspicious FNAs, 64% of Bethesda V FNAs, and 87% of Bethesda VI FNAs. Follicular and hurthle cells are normal cells found in the thyroid. I was told the only way to find out for sure is to have half my thyroid removed. I am so glad to find this as reading everyone's story helps me feel not so aloneTHANK YOU! 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 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). In May 2013 I spoke to Barbara Rath Smith the executive director of The American Thyroid Association and she said she was going to email articles as files to download and she did. Thyroid. It was found incidentally in an MRI I had for cervical spine pain. Thyroid 29:11151124. Currently, gene tests can provide more information as to whether an indeterminate nodule is a cancer or not. eCollection 2021. Right now my neck lymph nodes look good. I'm afraid I feel ok now then all of a sudden will begin feeling horrible.
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