afirma gsc suspicious 50

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. A test with a better NPV (negative predictive value), would be more usefu than ever in that situation. 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. Thyroid cancer is found in ~5% of thyroid nodules, so the vast majority are benign (noncancerous). Incidental papillary thyroid carcinoma, .2 cm on Left lobe and Thyroid right lobe: 1.2 cm nodule-Papillary thyroid carcinoma, conventional and follicular variant, histologically infiltrating into adherent skeletal muscle: .2 cm and the right lobe: 1.4 cm, both Afirma GEC or GSC a gene-expression classifier that identifies biopsies as "benign" or "suspicious," and mir-THYtype an mRNA-based classifier test. 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! B. I'm shocked that my voice is still completely in tact. Thank you. The aggressive one wants to cover his ass in the tiny chance you have an aggressive thyroid cancer, and the wait and see one is playing the odds that there is nothing to worry about, and that unneeded surgery has risks that are higher than the benefits in your case. At the end of the day, it is what it is now that I SWALLOWED (no pun intended) the I-131 pill, hopefully it won't work against me. The rest were called benign by the GEC. t=5283[/url]. I do not have calcifications but all 4 nodules are solid, hypoechoic and vascular. 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. Epub 2020 May 21. Can you expand on this? 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. 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. I've been battling hypothyroidism and suspicious thyroid nodules for 4 years. Here is what the Affirma test disclaimer said: Benign: Preformance characteristics not defined for nodules less than 1 cm diameter. Complex nodule. The original Afirma GSC validation study showed: 54% of ITNs return a benign Afirma GSC result (GSC-B) When categorized by the Afirma test as GSC-B, the risk of thyroid cancer is < 4% When categorized by the genomic test as suspicious (GSC-S), the risk of thyroid cancer is ~50% Conversely, when evaluating nodules with suspicious molecular testing, surgical rates were 88% and 89%, respectively, for GEC and GSC (P = 0.853) . Now can anyone shed some light on any negative effects of RAI on your body in the long-run? The surgeon recommended complete removal of my thyroid. I can learn to live healthier, and to appreciate each day, and to love and support more readily. There are risks and benefits to any decision - and humans are very bad at assessing both. Dr.Hershman then says, In a world where there are unlimited financial resources,both the oncogene and the GEC methods could be applied to all indeterminate nodules,but this approach is not practical currently. Now having dodged a few close bullets, I was like wobble head to my new endo's treatment plan which included 100 mci RAI though after reading my path report that I may be at little higher risk with "variant" than most others. I've enjoyed good health for my whole life. Federal government websites often end in .gov or .mil. No parathyroid tissue identified. Thyroid 2016;26:911-5. A certain type of thyroid cancer is going to converted to non-malignant or "borderline" status. Noninvasive follicular variant of papillary thyroid carcinoma and the Afirma gene-expression classifier. 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. 2016 Wiley Periodicals, Inc. Keywords: Thyroid nodule: an abnormal growth of thyroid cells that forms a lump within the thyroid. Advice needed please. 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. 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 However, FVPTC is currently classified as a type of "papillary" carcinoma, so the rate of diagnosis is also going to fall pretty substantially. http://www.thyroidboards.com/showthread.php? They call follicular neoplasms with hurthle cells FNOF. My blood tests came back totally normal and I am totally asymptomatic. What do I do? Others understand my need for more information. An official website of the United States government. I went under a fna biopsy and got the results stating that there's are 2 malignant tumors one on each side of my thyroid, and one is suspicions of papillary adenocarcinoma, the other one is suspicions of malignancy. The rate of malignancy in nodules suspicious by Afirma was 18.3% (11/60). 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. That didn't sit well with me. 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. I'm now 3 days post op and other than some difficulty swallowing and talking loud, I'm feeling great. Thyroid Fine Needle Aspiration Biopsy (FNAB): a simple procedure that is done in the doctors office to determine if a thyroid nodule is benign (non-cancerous) or cancer. Current analysis of thyroid biopsy results cannot differentiate between follicular or hurthle cell cancer from noncancerous adenomas. 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. http://onlinelibrary.wiley.com/doi/10.1002/cncy.21455/full. Found an endocrinologist who is willing to work with me on some more testing. Current analysis of thyroid biopsy results cannot differentiate between follicular or hurthle cell cancer from noncancerous adenomas. For the past year I've been seeing functional medicine doctors to see if I could shrink my nodules with diet and nutrition but when I got the positive Afirma test and the biggest nodule 3cm kept growing I finally decided to have surgery, which I had last Thursday. I don't think the reclassification was mentioned specifically in the WSJ article. BACKGROUND The pathology database was searched for all thyroid nodules with Afirma test results over a three year period, 2013-2015. Thanks for chiming in. The authors reported the following rates of final diagnoses for these specimens: 65% of cases had no cancer (ie. I found many people including more than a few on the Inspire site in their ThyCa forum who have unfortunately gotten false suspicious results from this test and as a result had totally unnecessary thyroid surgery,including this poor woman on thyroidboards.com who is the worst case I found so far,the Afirma test told her she had an 80% highly suspicious result and because of this her endocrinologist told her to expect cancer and that she had an 80% likelihood that her solid hypoechoic 1- 1 1/2 cm mildly suspicious as follicular neoplasm nodule was cancer,so she had totally unnecessary thyroid surgery for a benign nodule and was scared to death for nothing! Anyone have AUS nodule with suspicious Afirma results end up cancerous? It is such a major decision that the more info you have in making the decision the better. The Afirma gene sequencing classifier (GSC) performs better in indeterminate thyroid nodules than the Afirma gene expression classifier (GEC). On the day before Thanksgiving, I returned home from work to discover a recorded phone message from the endocrinologist's office. I'm a 57 year old male who took a full body scan 6 1/2 years ago and among other things a small 1 cm nodule was found on the right lobe of my thyroid. But, she ordered another ultrasound because she wants to see the images herself, rather than just rely on reports from the radiologist. I am wondering if anybody can comment on whether my case described below is considered to be reclassified according to the recently released guidelines. Have lots of decisions to make and just trying to do some homework. Multiple nodules. Careers. Hello, new here and confused, anxious and a bit worried. These 3 papers report the performance of these assays in evaluating Bethesda III and IV indeterminate biopsies. Accessibility Please let me know what you think. What should I know? The .gov means its official. Nevertheless, I am reluctant to just proceed particularly for the following reasons: 2) Partial or Total Thyroidectomy? Qualifiers of atypia in the cytologic diagnosis of thyroid nodules are associated with different Afirma gene expression classifier results and clinical outcomes. 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!) However the "suspicious" result of the Afirma GEC does not classify these indeterminate nodules further in determining appropriate management. Afirma was suspicious. I'm afraid I feel ok now then all of a sudden will begin feeling horrible. 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. For one thing, I had some pain on one side after biopsy. I have since found several more women who had false Afirma test results and had surgery and their nodules were also benign! The mindset of most surgeons is to cut it out - ignoring the risks of that approach. The Afirma Genomic Sequencing Classifier (GSC) is used to rule out malignancy and reclassify cytologically indeterminate (Bethesda III or IV) nodules to molecularly benign or suspicious ( 5 ). Most probably, a lot more lobectomies are going to be performed for indeterminate nodules since the level of certainty is going to drop. Glad to have found Inspire to learn more, and support others, and receive support. o The Afirma MTC testing must be billed as part of the Afirma GSC. Epub 2018 Apr 10. I'm fearful this is a Hurthle Cell Lesion, and I do not like what I have read. What was your experience? 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! With these genetic tests, patients and physicians have more information to feel confident about avoiding surgery or pursuing it based on the test results. However, I was not informed of this. All thyroid nodules with a "suspicious" Afirma GEC result were investigated. Unauthorized use of these marks is strictly prohibited. I have never really loved my endo, and have always felt like she was pressuring me into surgery. https://www.inspire.com/groups/thyca-thyroid-cancer-survivors-association/discussion/afirma-thyroid-analysis/. I find out my biopsy results next week. and I just found out that my Afirma test isn't being paid for by my insurance company on the grounds that its test is considered "experimental.". I almost want to cancel the surgery. I called back and left them a message that was at home, to call me back. Because of this rather benign course, some pathologists have even questioned whether this subgroup is a cancer after all. I'm a 39 years old male. The doc mentioned the thyroid and upon a physical exam felt the nodule, leading to the rest of the testing. Tumor is partially encapsulated with no capsular invasion or extrathyroidal extension identified. undefined will no longer be visible to you including posts, replies, and photos. 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. 5) What are your thoughts on these results? I had the ultrasound, and am waiting for my appointment with her to go over the images. After some research of my own, I decided to leave it. I am hesitant to go to surgery with the 30% cancer chance without more information. 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. PMC Bookshelf See Somatic Mutation Testing - Solid Tumors guideline for criteria. Follicular and hurthle cells are normal cells found in the thyroid. 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. But, I am concerned about the report I just received. Meanwhile I read a recent WSJ article about patients with ACTUAL thyroid cancer being offered a wait and see approach as there are so many issues after surgery--not just discomfort issues like fatigue, weight gain and so forth but also secondary cancers. My surgeon and endocrinologist said no further treatment is needed but to continue observation. 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