undefined will no longer be visible to you including posts, replies, and photos. Thank you. sharing sensitive information, make sure youre on a federal 2021 May 13;12:649522. doi: 10.3389/fendo.2021.649522. I opted to have the TT and it turned out it was cancerous and had spread to a few lymph nodes, so then I had right and left central neck dissections as well. The main goal was to help decide if my "suspicious for neoplasm" nodule was benign or not. Epub 2020 Aug 6. 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. Recently I change insurance and in doing so, my new doctor ordered a ultrasound which showed the nodule and he felt it was nothing to worry about. 85% were benign. Finally, the cells were sent to Afirma, Now I was growing concerned. It seems like with every ultrasound, some new suspicious characteristic pops up. 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! Each of my pre-surgical tests are pointing more and more in the wrong direction. Choosing to have the surgery was the most difficult decision ever, since I wasn't sure if my nodule was cancerous or not, and of course I didn't want to go through the surgery all for nothing. My Afirma test came back May 6 with what the company calls 40% "suspicious". You started down the rabbit hole by focusing on your thyroid gland for no good reason, since the melanoma is not related to anything regarding your asymptomatic thyroid. 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. So I was reading about the new kind of fna biopsy called Afirma, and I guess that my question is, is it worth getting it as a second opinion or should I go through with the surgery because of the results not being undetermined. They incidentally found a nodule on my right thyroid tru CTSCAN in Dec.2014. The Affirma Xpression Atlas is based on RNA sequencing. and I said this is not a good test,and he said I don't think it's a good test either! Any Insights? My question is then I guess, is it really that bad afterwards managing levels and the other side effects post TT? government site. Home Patients Portal Clinical Thyroidology for the Public October 2016 Vol 9 Issue 10 p.11-12, CLINICAL THYROIDOLOGY FOR THE PUBLIC 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. The site is secure. I didn't want to live with the risk, especially already being hypo and having nodules on the other side slowly growing. What do I do? Example of an Afirma patient report of a hypothetical 1.5 cm thyroid Since that time, the pain has all subsided -- I think the biopsy just roughed things up, but when they calmed down, I felt no pain whatsoever, again. The result of this 2.1 cm Bethesda IV nodule A is Arma GSC Benign, which suggests a low risk of cancer at approximately 4%. Wong KS, Angell TE, Strickland KC, Alexander EK, Cibas ES, Krane JF, Barletta JA. 2016 Wiley Periodicals, Inc. Keywords: Dr.Jerome Hershman. An evaluation of the molecular marker tests for thyroid cancer MeSH 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. Epub 2012 Oct 18. I find out my biopsy results next week. What was your experience? One > 4cm, but has tested benign by FNA 4 times 2) Partial or Total Thyroidectomy? Part 3: Afirma genetic testing for thyroid cancer - Running with a Others understand my need for more information. NTRK, RET, BRAF, and ALK fusions in thyroid fine-needle aspirates (FNAs). 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. It's really upsetting to suddenly be thrust into this with no symptoms, etc. Just had TT yesterday. benign), 25% of cases had follicular variant papillary thyroid cancer, 2% of cases had classical papillary thyroid cancer and 8% of cases had follicular thyroid cancer. I'm now 3 days post op and other than some difficulty swallowing and talking loud, I'm feeling great. result (eg, benign or suspicious) Public Comment. Clinician should therefore exercise caution in using this result for treatment decisions. I knew it was not good news. 5) What are your thoughts on these results? Indeterminate means the pathologist cannot tell if the nodule is benign or malignant with certainty. 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. 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. Thyroid Cancer - Afirma& Genomic Sequencing Classifier - Veracyte Abigail. Our offering enables physicians to answer multiple clinical questions for their thyroid patients using a single, minimally invasive fine needle aspiration (FNA) sample. -No Size changes of Nodule in last 2-3 months (duration of time to get all of these tests) My Enfo bumped up my Synthroid right away to adjust for the surgery. Afirma GEC or GSC a gene-expression classifier that identifies biopsies as "benign" or "suspicious," and mir-THYtype an mRNA-based classifier test. This site needs JavaScript to work properly. He then says, However,another interpretation is that the method can be used only to classify a nodule as benign and the "suspicious" category by GEC should not be used. He wisely advised that I need a thyroid ultrasound which revealed the nodule had grown to 2.2cm. He tried to console me but he was also upset. Found an endocrinologist who is willing to work with me on some more testing. 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 . The biopsy (Afirma) was indeterminate with GSC suspicious with a 50% ROM. http://www.glandsurgery.org/article/view/1002/1193. The GSC correctly identified 41 of 45 malignant samples as suspicious, yielding a sensitivity of 91.1%, and 99 of 145 . Thyroid. Afirma was suspicious. The pathology database was searched for all thyroid nodules with Afirma test results over a three year period, 2013-2015. No one was telling me that. 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. Patients usually return home or to work after the biopsy without any ill effects. And the 3rd test was Afirma which came back "suspicious". Clipboard, Search History, and several other advanced features are temporarily unavailable. B. At first it sounded like only the encapsulated variety was going to be included in the reclassification, but more recently it seems that non-encapsulated and non-invasive FVPTC is also going to be included. Patient medical records were retrospectively reviewed for clinical history, FNA results, radiologic findings, management and follow-up. Epub 2018 Apr 10. Suspicious Nodule Surgery the Only Option? However, that information will still be included in details such as numbers of replies. Evaluation of the Afirma Gene Expression Classifier to determine Living beings depend on genes, as they code for all proteins and RNA chains that have functions in a cell. :-). I wasn't one to resist. Molecular testing for indeterminate thyroid nodules: Performance of the Afirma gene expression classifier and ThyroSeq panel. At this point, I was exasperated by all of the running around, but fine. Thus, 54 NIFTP cases were established, all with a suspicious Afirma GEC result. Which means I would still be paying this amount to the hospital if I didn't pay it to Affirma. 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! Background: -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 Bethesda, MD 20894, Web Policies 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 . The Affirma Genomic Sequence Classifier (GSC) is based on DNA sequencing. 1. 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 biopsy (Afirma) was indeterminate with GSC suspicious with a 50% ROM. 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.". 2018 Jul;126(7):471-480. doi: 10.1002/cncy.21993. Genes hold the information to build and maintain an organisms cells and pass genetic traits to offspring. 2016 Jul;26(7):911-5. doi: 10.1089/thy.2015.0644. I didn't make a big deal about the cost because I am having surgery and they money I paid was my 20% co-pay and my out of pocket limit is almost met. Disclaimer. They did not address that issue in their letter, just my income. My oldest daughter has a friend who has survived thyroid cancer, and SHE was sure to tell ME about that. I was told that my thyroid needs to be removed (at least half, possibly all). She then tells me that at a recent conference, there was a lot of discussion of Afirma, and the general consensus seemed to be that it was good at detecting papillary cancer, but not necessarily follicular. Results came back 50% Suspicious for FN(Follicular Neoplasm) with positive HRAS c.18HRAS c.182A>G (Q61R) I have never really loved my endo, and have always felt like she was pressuring me into surgery. BTW, I'm about to turn 50 and I have no thyroid issues other than this. I am very resistant to the thought of having a gland removed that is functioning perfectly fine, if it isn't cancer. And he said he doesn't think the Afirma test is as accurate as they say. There are four types of FVPTV: encapsulated with invasion, encapsulated without invasion, unencapsulated non-invasive and unencapsulated and invasive into the surrounding parenchyma of the gland. Before 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 The mindset of most surgeons is to cut it out - ignoring the risks of that approach. 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. Cytopathol. 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. Without my knowledge 4/5 of my FNA biopsies came out fine but 1/5 had "atypical" cells and they were sent to Afirma without my knowledge. Repeat Fine Needle Aspiration Cytology Refines the Selection of Thyroid Nodules for Afirma Gene Expression Classifier Testing. He recently called me back and said that my criticism of the test is valid. This test is performed by the company Veracyte Inc. BACKGROUND Thyroid nodules are very common, occurring in 30-50 % of patients. It's pretty difficult being the patient trying to sort this all out. 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. The surgeon was great. Papillary Thyroid Cancer: the most common type of thyroid cancer. 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! Currently, gene tests can provide more information as to whether an indeterminate nodule is a cancer or not. Afirma BRAF V600E o Afirma BRAF testing may be considered for either GSC or FNA suspicious or malignant results. Afirma result was suspicious in 69 cases. Is one easier to recover from ? The surgeon recommended complete removal of my thyroid. Of the 343 nodules that underwent the GEC test, 178 cases (51.9%) were considered suspicious for cancer. I am scheduled to have a TT on March 9th and I wish I felt a little better about my decision. Hello. However, researchers found that when the Afirma GSC identified a thyroid nodule with a TSHR mutation as suspicious, the risk of malignancy was 15.3%, a level of risk for which most physicians. The Afirma GSC is designed to help clinicians manage these patients. Thyroid nodules are very common, occurring in up to 50% of individuals. 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. Noninvasive follicular variant of papillary thyroid carcinoma and the Afirma gene-expression classifier. Are you sure you want to block this member? Long-Term Outcomes of Thyroid Nodule AFIRMA GEC Testing and Literature Review: An Institutional Experience. Variant: Afirma XA: Informs selection of surgical and therapeutic decisions for Afirma GSC Suspicious, Bethesda V, and Bethesda VI nodules 1 Is clinically validated 1 and informed by The Cancer Genome Atlas (TCGA), 2 extensive published literature, and Veracyte R&D discovery using nearly 40,000 samples 3 It was found incidentally in an MRI I had for cervical spine pain. the GSC is to further differentiate indeterminate FNA. Cancer Cytopathol. Cancer-Associated Genes: these are genes that are normally expressed in cells. Genes hold the information to build and maintain an organisms cells and pass genetic traits to offspring. Neither will talk to the other. Christmas got in the way, so January 22 is my date. 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). 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.