afirma gsc suspicious 50

I have since found several more women who had false Afirma test results and had surgery and their nodules were also benign! they misclassify benign nodules as suspicious! I am so new to all this that I don't know what this means. SUMMARY OF THE STUDY Afirma said NEGATIVE for BRAF and Meduliary but still assigned a classification of "Suspicious" with 40% chance of cancer. Thyroid cancer is found in ~5% of thyroid nodules, so the vast majority are benign (noncancerous). This occurs in 1520% of biopsies and often results in the need for surgery to remove the nodule. BTW, I'm about to turn 50 and I have no thyroid issues other than this. 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. I know, that is still pricey but seems cheap compared to $6,000. Thyroid nodule: an abnormal growth of thyroid cells that forms a lump within the thyroid. 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! Maternal side history of goiter in females, no known thyroid cancer, but late breast cancer and colon cancer Current analysis of thyroid biopsy results cannot differentiate between follicular or hurthle cell cancer from noncancerous adenomas. The GSC incorporates nuclear and mitochondrial RNA transcriptome gene expression, RNA sequencing, and genomic copy number analysis. Don't get me wrong, it hurts, but I'm able to swallow (soft foods) and talk ok. Here is what the Affirma test disclaimer said: Benign: Preformance characteristics not defined for nodules less than 1 cm diameter. 4. I'm a 39 years old male. Clipboard, Search History, and several other advanced features are temporarily unavailable. After reading many stories, I didn't know what to expect. Local surgical pathology diagnoses were available for 11 of these nodules. The surgeon was great. 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. I tried to avoid it for 10 years I am 52 years old , I have a multinodular goiter with many, many , many nodules,the biggest on the left side 2.2 cm right side 2.6 all TSH test results are good , in fact , my thyroid is fonctioning perfectly well. 2016 Jul;26(7):911-5. doi: 10.1089/thy.2015.0644. 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." If benign = no surgery, IF suspicious or malignant = surgery. Partially Encapsulated Follicular Variant of Papillary Carcinoma. The Afirma GSC is a cancer rule-out test with a high negative predictive value so that cytologically indeterminate (Bethesda III/IV)2thyroid nodules with an Afirma GSC benign result can be considered for clinical observation in lieu of diagnostic surgical resection (Fig. 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! Currently, gene tests can provide more information as to whether an indeterminate nodule is a cancer or not. Lastly I do 25mcg of levothyroxine once a day for Hypothyroidism, it was prescribed based on lab results, not on how I was feeling. So the jump from that mentality to that of, "oh, I can get cancer, too" has big a huge one for me. 2020 May;162(5):634-640. doi: 10.1177/0194599820911718. The doctor uses a very thin needle to withdraw cells from the thyroid nodule. 2016 Wiley Periodicals, Inc. Keywords: The overall PPV of an Afirma GSC suspicious nodule was 47%, regardless of variant/fusion status. Thyroid. 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! A test with a better NPV (negative predictive value), would be more usefu than ever in that situation. Disclaimer. On May 8th endocrinologist Dr.Steven P.Hadak who with Dr. David S. Rosenthal co-authored one of these studies for The American Thyroid Association's Clinical Affairs Committee called,Information For Clinician's:Commercially Available Molecular Diagnosis Testing In The Evaluation Of Thyroid Nodule Fine-Needle Aspiration Specimens called me back and was very nice,he even had a patient waiting! There are risks and benefits to any decision - and humans are very bad at assessing both. Thanks. Noninvasive Follicular Variant of Papillary Thyroid Carcinoma and the Afirma Gene-Expression Classifier. He said there was no lymph node involvement but there's no way to tell until final path. Home Patients Portal Clinical Thyroidology for the Public February 2020 Vol 13 Issue 2 p.13-14, CLINICAL THYROIDOLOGY FOR THE PUBLIC Of the 164 nodules included in the study with the GSC test, suspicious nodules were found in 39 of the 164 nodules (23.7%). I've read a lot about this test (both good and bad). 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!) - Partial was recommended at first, though we are leaning total now with the remainder of tests now complete. Thyroid nodules are commonly found on ultrasound of the neck and the evaluation of a thyroid nodule may include thyroid biopsy. Others understand my need for more information. At least as accurate as FNA, or that was my understanding. Otolaryngol Head Neck Surg. The main goal was to help decide if my "suspicious for neoplasm" nodule was benign or not. and transmitted securely. 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 Afirma MTC may not be billed separately using an additional unit or procedure code. The Afirma MTC may not be billed separately using an additional unit or procedure code. Are you sure you want to block this member? This study indicates that the newer Afirma GSC test is superior to the Afirma GEC test by better predicting which indeterminate nodules are more likely to be cancers and should be removed while maintaining the same or better performance of predicting which indeterminate nodules are benign and can be monitored without surgery. 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. 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. 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. 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 results were suspicious of papillary cancer, but not conclusive. http://onlinelibrary.wiley.com/doi/10.1002/cncy.21455/full. Afirma GEC or GSC a gene-expression classifier that identifies biopsies as "benign" or "suspicious," and mir-THYtype an mRNA-based classifier test. Unauthorized use of these marks is strictly prohibited. something nodule with a majority of Hurthle cells with normal thyroid blood tests and the Afirma test came back 40% suspicious,it grew even bigger in two years and was hypoechoic and vascular on the ultrasound like mine and she said this concerned her and the radiologist,she said (she said my nodule sounds a lot like hers except hers was bigger) so she had half her thyroid out and this nodule was benign! My Enfo bumped up my Synthroid right away to adjust for the surgery. If all nonsurgical GEC benign cases were actually benign, when evaluating the cases that had surgery, the chance that a GEC suspicious nodule was actually cancer was 33.3% and the chance that a GEC benign nodule was actually benign at surgery was 98.2%. Ultrasound reports unfortunately not very informative other than size. 2. Method: 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. I am also concerned about hormone replacement, would like some personnal comments on recovery from Lobectomy versus TT . Papillary thyroid carcinoma, Follicular Variant, 2.1 cm in greatest dimension, present in mid to lowe pole, woth prior FNA site changes. 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. Cytopathol. Advice needed please. Bugs me. Hello, new here and confused, anxious and a bit worried. I had the ultrasound, and am waiting for my appointment with her to go over the images. Glad to have found Inspire to learn more, and support others, and receive support. But, I'm also tired of living with the uncertainty and semi-annual nerve sessions after each ultrasound. False positive rate of Afirma was 56% (32/57). So now I feel I have no choice to take it out (the nodule also grew .5 cm since the Aug test). Any help really will be appreciated. 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. The site is secure. 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. 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? 2021 Oct 7;5(11):bvab148. -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 There are 3 variants of papillary thyroid cancer: classic, follicular and tall-cell. Afirma was suspicious. Also difficult is the reaction from others. eCollection 2021 Nov 1. 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. One > 2cm, undetermined twice and "suspicious for follicular neoplasm" the most recent FNA -38yrs old When the nurse called she couldn't even tell me results over he phone -- she said she didn't know them -- but set up an appointment for end of the following week -- another wait. I have 1.6 cm nodule on my right lobe. He recently emailed me back and said,as we discusssed on the phone,he agrees with many of my concerns about the Afirma test. Have lots of decisions to make and just trying to do some homework. The cells need to be "fresh." A Indeterminate Suspicious (ROM ~50%) Negative NRAS:p.Q61R c. 182A>G TSHR:p.M453T c. 1358T>C ISTHMUS A UPPER MIDDLE LOWER RIGHT LEFT See Xpression Atlas results overview page for additional information . o The Afirma MTC testing must be billed as part of the Afirma GSC. The .gov means its official. I'm a 39 years old male. I'm not against surgery if needed, but wondering shouldn't it be followed for a bit before such a drastic measure is taken. The rest were called benign by the GEC. 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. The mindset of most surgeons is to cut it out - ignoring the risks of that approach. Thyroid 29:11151124. The pathology report on the removed nodule said: Later that week I received a call telling me it was suspicious and was referred to an ENT which I saw yesterday. 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. Among the 25 papers that approached Afirma GEC, four studies enrolled an additional number of 635 TNs from 596 patients to evaluate the Afirma GSC (16, 17, 57, 70). Methods: Living beings depend on genes, as they code for all proteins and RNA chains that have functions in a cell. On this topic from this forum member bmcm2girls said she too had a false suspicious result from the Afirma test and her nodule was benign when removed. I was informed in August of 2013 after a FNA that one of my nodules was suspicious and the recommendation was a TT. I am very athletic , very healthy and happy ,don't want to give up any of that !!! Second, this nodule has been stable and has not grown from the first day it was discovered. Thyroid cancer is found in ~5% of thyroid nodules, so the vast majority are benign (noncancerous). (Afirma GSC suspicious, suspicious for malignancy, or malignant cytopathology) ,2,4,8 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. 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. Dincer N, Balci S, Yazgan A, Guney G, Ersoy R, Cakir B, Guler G. Cytopathology. (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.) 42 year old female. Qualifiers of atypia in the cytologic diagnosis of thyroid nodules are associated with different Afirma gene expression classifier results and clinical outcomes. Neither will talk to the other. 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! I have multiple nodules. 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 doc mentioned the thyroid and upon a physical exam felt the nodule, leading to the rest of the testing. A thyroid nodule biopsy can be benign (normal), malignant (cancer) or indeterminate. MeSH Rationale: Crosswalk to 81545 ($3,600) 81545 describes the original Afirma classifier; when . [url=http://www.thyroidboards.com/showthread.php? He also says that out of 61 follicular neoplasms that were benign the Afirma test misclassified 31 of them as suspicious. Afirma Gene Expression Classifier: a test for a group of molecular markers in thyroid biopsy specimens in order to determine the likelihood that a thyroid nodule is benign or cancerous. It just really annoys me that doctors can order tests that cost us money without our consent. He later called and said he was sending me for a biopsy. Thoughts or experiences?? Afirma BRAF V600E o Afirma BRAF testing may be considered for either GSC or FNA suspicious or malignant results. Neither will talk to the other. Upenn top thyroid pathologists including Dr.Virginia Lavosi report that follicular neoplasms with oncocytic (hurthle cells)often are misclassified as suspicious by the Afirma test! But in my case, it was a risk well worth taking. National Library of Medicine government site. It seems like with every ultrasound, some new suspicious characteristic pops up. 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. But that's a personal issue I'll have to work out in time. My radiologist determined that the smallest one had follicular cancer cells in her description but called it indetermined. 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. 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!) I posted the below post on this forum on several different topics since 2013. The two most common molecular marker tests are the Afirma Gene Expression Classifier and Thyroseq, A publication of the American Thyroid Association, Change In Thyroid Nodule Volume Calculator, Find an Endocrinology Thyroid Specialist, Clinical Thyroidology for the Public (CTFP).

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