No one was telling me that. I'm a lumpy person, I told my husband. 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!) Cancer Cytopathol. She has other small nodules on her other thyroid lobe. I had a biopsy for 4 nodules 2 mos ago. (Afirma GSC suspicious, suspicious for malignancy, or malignant cytopathology) ,2,4,8 Thanks so much! Afirma said NEGATIVE for BRAF and Meduliary but still assigned a classification of "Suspicious" with 40% chance of cancer. False Positives. So the probabilities of malignancy for the various Bethesda risk categories are going to change. Multiple nodules. I have met with multiple surgeons, and am meeting with the one I am selecting on Friday and wanted some info on what to do, and how to proceed. I find out my biopsy results next week. But still my labs are all within normal range. 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. I immediately started crying, knowing that a phone call wasn't "the good news." However, its relatively low positive predictive value (PPV) limited its use as a classifier for patients with suspicious results. Should I be treating this as a Hurthle Cell Lesion, or should I just relax. 2021 Oct 7;5(11):bvab148. Unauthorized use of these marks is strictly prohibited. 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. I'd done enough research to know that Thyroid cancer is generally treatable, and was sure to tell them about that. https://www.inspire.com/groups/thyca-thyroid-cancer-survivors-association/discussion/genetic-test-two-different-results/reply/6888430/?msg_activity=reply_posted. As I have learned on this board, just 'taking a pill' for the rest of your life isn't as easy as it sounds. Mine did, and that can also be a sign of cancer. 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. 4,6 In addition to the benign versus malignant classifier, the Afirma GSC suite includes Papillary thyroid cancer is the most common type of thyroid cancer. The Afirma gene sequencing classifier (GSC) performs better in indeterminate thyroid nodules than the Afirma gene expression classifier (GEC). Thyroid Fine Needle Aspiration Biopsy (FNAB): Change In Thyroid Nodule Volume Calculator, Find an Endocrinology Thyroid Specialist, Clinical Thyroidology for the Public (CTFP). Sometimes you only hear the bad stories and not the good so I wanted to share mine. Of the 343 nodules that underwent the GEC test, 178 cases (51.9%) were considered suspicious for cancer. 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! 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." It's barely even hoarse. I knew it was not good news. These results show an improved accuracy for the GSC as compared with the GEC. I almost want to cancel the surgery. - Partial was recommended at first, though we are leaning total now with the remainder of tests now complete. Dr.Jerome Hershman. 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! Have lots of decisions to make and just trying to do some homework. -Afirma Test: "Suspicious for Malignancy" - NEGATIVE for BRAF, MTC, RET/PTC1 and RET/PTC3 Epub 2020 May 21. My surgeon and endocrinologist said no further treatment is needed but to continue observation. Hello. 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. 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 . I agree that you should have been consulted for the genetic test!! Can you expand on this? t=5283], http://www.thyroidboards.com/showthread.php? I hope this helps calm some fears for others who may be going through the same thing. There are risks and benefits to any decision - and humans are very bad at assessing both. 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. Finally, the cells were sent to Afirma, Now I was growing concerned. Like she was just trying to tie up loose ends, and I happened to be one of those loose ends. However, the results are not conclusive. For nodules determined to be GSC Suspicious or with a cytopathology diagnosis of Bethesda V or VI, physicians ordered XA by checking a box. Thyroid nodules are commonly found on ultrasound of the neck and the evaluation of a thyroid nodule may include thyroid biopsy. Cytopathol. The moment that I've been so nervous about finally came yesterday. 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. I understand that Afirma tends to have a lot of false positives, but it's supposed to be fairly accurate for negative results. And the 3rd test was Afirma which came back "suspicious". This approach is being marked by several laborartories and was reviewed in the December 2011 issue of Clinical Thyroidology. The Afirma Xpression Atlas for thyroid nodules and thyroid cancer metastases: Insights to inform clinical decisionmaking from a fineneedle aspiration sample Jeffrey F. Krane, MD, PhD,1 Edmund S. Cibas, MD,2 Mayumi Endo, MD,3 Ellen Marqusee, MD,4 Mimi I. Hu, MD,5 Christian E. Nasr, MD,6 Steven G. Waguespack, MD,5 Lori J. Wirth, MD,7 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 . . Have lots of decisions to make and just trying to do some homework. 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. result (eg, benign or suspicious) Public Comment. Results: Thirty-eight TP53 variants were present among >13,000 Bethesda III/IV Afirma GSC Suspicious samples. Polavarapu P, Fingeret A, Yuil-Valdes A, Olson D, Patel A, Shivaswamy V, Matthias TD, Goldner W. J Endocr Soc. 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. 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. The benign call rate for GSC was 76.2%. One > 2cm, undetermined twice and "suspicious for follicular neoplasm" the most recent FNA All my blood tests and tsh levels are in the normal range. On cytologic evaluation 3.0% of the cases were non diagnostic (ND), 9% benign, 62% AUS, and 26% suspicious for neoplasm (SN). I called and almost everyone has that risk if it is suspicious. However, FVPTC is currently classified as a type of "papillary" carcinoma, so the rate of diagnosis is also going to fall pretty substantially. 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. Suspicious readings of the Afirma gene-expression classifier include some noninvasive encapsulated follicular variant of papillary thyroid carcinomas. Baca SC, Wong KS, Strickland KC, Heller HT, Kim MI, Barletta JA, Cibas ES, Krane JF, Marqusee E, Angell TE. A 36% Increase in Specificity With Afirma GSC Versus Older Test . The Affirma Xpression Atlas is based on RNA sequencing. My doctor then sent me to an endocrinologist for a biopsy which came back with atypical but inconclusive results. Everyone's story and experience seemed to be totally different. The doctor uses a very thin needle to withdraw cells from the thyroid nodule. I'm a 39 years old male. Bugs me. (And myself.) 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. 42 year old female. 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]). This did not surprise me since I had researched "suspicious." My surgeon wants to operate right away stating that these kind of results have a 90% truancy for cancer to be present. I posted the below post on this forum on several different topics since 2013. 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! 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! National Library of Medicine Later that week I received a call telling me it was suspicious and was referred to an ENT which I saw yesterday. 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. Hopefully soon afterward, I'll learn about whether or not the cells are cancerous and can begin to plan my next steps toward recovery. Epub 2020 Mar 17.