Unauthorized use of these marks is strictly prohibited. He is very calm and laid back, and prefers to take a more controlled approach to everything, but I'm feeling a more aggressive approach is warranted. This occurs in 1520% of biopsies and often results in the need for surgery to remove the nodule. 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. This is about 25% of all thyroid cancers currently. 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. Please let me know what you think. The third biopsy was sent for genetic testing which came back as suspicious. 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 . Awaiting pathology. 4,6 In addition to the benign versus malignant classifier, the Afirma GSC suite includes The Afirma Xpression Atlas for thyroid nodules and thyroid cancer I wish you luck in whatever you decide. Of the 343 nodules that underwent the GEC test, 178 cases (51.9%) were considered suspicious for cancer. And it keeps growing. He wisely advised that I need a thyroid ultrasound which revealed the nodule had grown to 2.2cm. 2016 Wiley Periodicals, Inc. Keywords: The Afirma test results came back Benign on left side and Suspicious 40% on the right side . 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. So far, no problems with calcium. Long story short, after consulting a reputable endo with 25+ years of exp and hearing that I needed a total neck ultrasound to rule out any possible cancer spread to my lymph-nodes, I could not help but ask him if thyroid cancer is the slowest growing of all cancers and why the concern of cancer-spread only after year after diagnosis.here's the bomb I was not ready for or did not expect: my doc's said that he could not rule out the possibility this cancer may have started back in 2002 but remained to be such a small size of 1.4 cm for all these years. 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 Mol Genet Genomic Med. 8600 Rockville Pike 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. Is one easier to recover from ? 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]). However, its relatively low positive predictive value (PPV) limited its use as a classifier for patients with suspicious results. 2017 May;125(5):313-322. doi: 10.1002/cncy.21827. 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). The doctor uses a very thin needle to withdraw cells from the thyroid nodule. undefined will no longer be visible to you including posts, replies, and photos. Dr.Jerome Hershman. After some research of my own, I decided to leave it. Indeterminate means the pathologist cannot tell if the nodule is benign or malignant with certainty. False Positives. 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 think my biggest problem is what I read on the internet as far as all the problems afterwards. Largest is 2.3(previously 1.8cm in 2014) different test center though. How do Afirma GSC & Xpression Atlas tests work? What do they mean Thyroid nodule: an abnormal growth of thyroid cells that forms a lump within the thyroid. All I can say is that in reviewing my ultrasounds and the report from the interventional radiologist and the Affirma report, I have noticed that there are inconsistencies in even the reported measurements of the nodules and now that I have read further into studies done on people undergoing thyroid removal after getting "Suspicious"/40% of Cancer Affirma results, there are many more false positives than Afirma would have you understand. Partially Encapsulated Follicular Variant of Papillary Carcinoma. That was a hard Thanksgiving. The aim of this study was to determine the clinical performance of the GSC as compared with the GEC at one academic medical center. Thyroid Nodules: https://www.thyroid.org/thyroid-nodules/. But, I am concerned about the report I just received. detect variants in greater than 50 genes. 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 . 2013 Dec;24(6):385-90. doi: 10.1111/cyt.12021. Don't get me wrong, it hurts, but I'm able to swallow (soft foods) and talk ok. Some people say I should have had my thyroid out years ago. He said this Afirma test is wrong half the time misclassifying benign nodules as suspicious,(I'm sure it's even more than half!) Afirma GSC(NOT GEC) 50% Suspicious - Thyroid cancer - Inspire Everyone's story and experience seemed to be totally different. At the end of his great article in the journal Clinical Thyroidology August 2012 criticizing the inaccuracies and unreliabilities of the Afirma test, endocrinologist of 50 years Dr.Jerome Hershman says, Currently the Veracyte Affirma GEC method "retails" for 3,350 plus 300 for cytopathology. Should I be treating this as a Hurthle Cell Lesion, or should I just relax. It seems like with every ultrasound, some new suspicious characteristic pops up. Current analysis of thyroid biopsy results cannot differentiate between follicular or hurthle cell cancer from noncancerous adenomas. :-). Used for FNA indeterminate nodules (bethesda III-IV). Results: Thirty-eight TP53 variants were present among >13,000 Bethesda III/IV Afirma GSC Suspicious samples. Now can anyone shed some light on any negative effects of RAI on your body in the long-run? No lymphovascular invasion is identified. I'm looking for any and all help and/information you can share with me. One > 2cm, undetermined twice and "suspicious for follicular neoplasm" the most recent FNA I was told my path report from the local hosp was inconclusive so it had to be sent to Mayo Clinic and after almost three weeks after my surgery, I got the word that it was cancerous. I was informed in August of 2013 after a FNA that one of my nodules was suspicious and the recommendation was a TT. PDF Pages: Patient Report Client Id: Afirma Req PDF AFIRMA REQ: Sample Patient Report I could feel food getting lodged in my throat, and felt a pinch like a nerve at times, too. The remaining 18% were malignant. o The Afirma MTC testing must be billed as part of the Afirma GSC. 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. The Xpression Atlas reports 905 genomic variants and 235 fusion pairs on GSC Suspicious, Suspicious for Malignancy (SFM), and Malignant FNA samples at the time of diagnosis. Please, I am looking for any and all thoughts. 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. Clipboard, Search History, and several other advanced features are temporarily unavailable. The https:// ensures that you are connecting to the But still my labs are all within normal range. https://www.inspire.com/groups/thyca-thyroid-cancer-survivors-association/discussion/afirma-thyroid-analysis/. Surgical margins: negative for tumor (tumor is < 0.1cm from margin) I also read on this Inspire site in their Thyroid Cancer Survivors Association forum,a woman had a 2cm indetrminate nodule that everyone was concerned about and her Afirma test came out suspicious or still indeterminate,and she had her thyroid removed,it turns out that the 2cm nodule was benign but they found tiny papillary cancers all under 5mm that weren't even seen on the ultrasound! She also said that her surgeon also had 5 other patients that had the Afirma test done,and said their nodules were suspicious too and they all were found to benign after they were removed! Conversely, when evaluating nodules with suspicious molecular testing, surgical rates were 88% and 89%, respectively, for GEC and GSC (P = 0.853) . I am wondering if anybody can comment on whether my case described below is considered to be reclassified according to the recently released guidelines. http://biotechstrategyblog.com/2012/06/veracyte- afirma-gene-expression-classifier-thyroid-cancer- diagnostic-test.html/ I'm sure that over the years as more people have this Afirma test done,there will be even more people posting on thyroid and general health boards about getting false "suspicious" results from it! My question is then I guess, is it really that bad afterwards managing levels and the other side effects post TT? I'm not sure what the exact terminology is going to be. My doctor then sent me to an endocrinologist for a biopsy which came back with atypical but inconclusive results. New Data Show Strong Performance of Veracyte's Afirma GSC in Real-World Hello. The Afirma Xpression Atlas for thyroid nodules and thyroid cancer Genes hold the information to build and maintain an organisms cells and pass genetic traits to offspring. This isn't saying that Afirma's test isn't useful. While most thyroid nodules are non-cancerous (Benign), ~5-10% are cancerous. 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 So much good info but I wish I had read this before I had agreed with my endo on his prescription for rai:( In fact, i am currently on my fifth day of my 7-10 day rai staycation. Molecular markers can be used in thyroid biopsy specimens to either to diagnose cancer or to determine that the nodule is benign. A group of expert pathologists have recently identified a subgroup of papillary thyroid cancer called noninvasive follicular variant papillary thyroid cancer that has a very low risk of relapsing after surgical removal. My Endo thinks I should see a thyroid surgeon and my other doctor wants to repeat ultrasounds in 4 months, adopting a wait and see approach. The results were suspicious of papillary cancer, but not conclusive. The oncogene molecular method misses cancers that do not express the oncogenes tested,but has the advantage of having a much lower rate of false positives as compared with the GEC method,assuming that "suspicious" is positive. Afirma GSC: Better as One Joshua Klopper, MD March 28, 2023 - Afirma 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!) I am not afraid of the surgery, only would really be disapointed if a vital organ was removed from my body for nothing. Fingers crossed they come back negative for cancer! They sent me home with 125mcg of Synthroid, calcitrol, and calcium. http://www.glandsurgery.org/article/view/1002/1193 Biotech Strategy Blog in this post by Pieter Droppert June 28,2012 Also mentions 48% of nodules falsely called "suspicious" for cancer and can cause many people to have unnecessary thyroid surgery when they don't have cancerous thyroid cells!
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