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These results do not change the risk of malignancy of the (ROM) of the Afirma GSC suspicious result." Sorry for such a long post, but as Im sure you remember, those first few days after receiving this type of news, Im full of questions and anxiety. Thyroid Nodules: https://www.thyroid.org/thyroid-nodules/. 4. How Does the Afirma Genomic Test Perform in the Real World? Thyroid Fine Needle Aspiration Biopsy (FNAB): Change In Thyroid Nodule Volume Calculator, Find an Endocrinology Thyroid Specialist, Clinical Thyroidology for the Public (CTFP). 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. I am still holding off on surgery for now. One of the hardest things about all of this is the adjustment. undefined will no longer be visible to you including posts, replies, and photos. I was informed in August of 2013 after a FNA that one of my nodules was suspicious and the recommendation was a TT. Hi, I am joining this group because I was recommended surgery.. 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. Personally, I think getting the AFIRMA test done is a good thing. The rate of malignancy in nodules suspicious by Afirma was 18.3% (11/60). The GSC incorporates nuclear and mitochondrial RNA transcriptome gene expression, RNA sequencing, and genomic copy number analysis. In such cases, testing of molecular markers related to thyroid cancer may help determine the risk of cancer. It's barely even hoarse. The pathology report on the removed nodule said: Evaluation of the Afirma Gene Expression Classifier to determine 2021 Aug;31(8):1253-1263. doi: 10.1089/thy.2020.0969. 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.". :-). Of the 164 GSC nodules, 29 (17.6%) underwent thyroid surgery. Partially Encapsulated Follicular Variant of Papillary Carcinoma. The biopsy (Afirma) was indeterminate with GSC suspicious with a 50% ROM. HHS Vulnerability Disclosure, Help But still my labs are all within normal range. So, if you were going to go down that route then this will save you from having a second biopsy. Afirma GSC: Better as One Joshua Klopper, MD March 28, 2023 - Afirma Afirma Genomic Sequencing Classifier and Xpression Atlas - PubMed I had a lobectomy sep. 30th. Sometimes, thyroid biopsy specimens are indeterminate, meaning that thyroid cancer cannot be definitively ruled in or out. Fingers crossed they come back negative for cancer! He tried to console me but he was also upset. Thyroid bloodwork normal. My surgeon wants to operate right away stating that these kind of results have a 90% truancy for cancer to be present. Another problem with Afirma is that pretty soon they are going to have to adjust the test to the reclassification of non-invasive FVPTC. Paratracheal nodule (inclduing B1FS): Thyroid Parenchyma, negative for tumor. Epub 2020 May 21. 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. I am so new to all this that I don't know what this means. I don't know if I'm speaking too soon, but the pain isn't as bad as I thought it would be. The original Afirma Xpression Atlas (XA) panel reported on 761 genomic variants and 130 fusion pairs from 511 genes ( 6 ). It is unclear whether mutations in these genes cause the cancer or are just associated with the cancer cells. 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. Thyroid nodule: an abnormal growth of thyroid cells that forms a lump within the thyroid. I welcome your thoughts on my case. She has other small nodules on her other thyroid lobe. Molecular markers can be used in thyroid biopsy specimens to either to diagnose cancer or to determine that the nodule is benign. Frontiers | Analytical Verification Performance of Afirma Genomic Hello, 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! The Afirma Genomic Sequencing Classifier (GSC) classifies cytologically indeterminate thyroid nodules as molecularly benign or suspicious. But in my case, it was a risk well worth taking. A 36% Increase in Specificity With Afirma GSC Versus Older Test . http://www.glandsurgery.org/article/view/1002/1193. I know, that is still pricey but seems cheap compared to $6,000. and transmitted securely. 8600 Rockville Pike 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). 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. After reading many stories, I didn't know what to expect. Additionally, there is an increase in the benign call rate with GSC, which in this study decreased surgical interventions by 68%. There are 3 variants of papillary thyroid cancer: classic, follicular and tall-cell. I find out my biopsy results next week. Suspicious for neoplasm - Veracyte genomic testing? - MedHelp Polavarapu P, Fingeret A, Yuil-Valdes A, Olson D, Patel A, Shivaswamy V, Matthias TD, Goldner W. J Endocr Soc. Finally, the cells were sent to Afirma, Now I was growing concerned. 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. 2) Partial or Total Thyroidectomy? A month ago I had the Afirma test and it came back positive - suspicious for cancer which increased my chance from 5% to 50%. t=5283], http://www.thyroidboards.com/showthread.php? The Afirma Xpression Atlas for thyroid nodules and thyroid cancer PMC 2021 May 13;12:649522. doi: 10.3389/fendo.2021.649522. Without my permission my specimen was sent to Affirma and their results were Benign, so my radiologist amended her results to benign for all 4 nodules. 5) What are your thoughts on these results? These 3 papers report the performance of these assays in evaluating Bethesda III and IV indeterminate biopsies. Everyone's story and experience seemed to be totally different. The aim of this study was to determine the clinical performance of the GSC as compared with the GEC at one academic medical center. 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. I'm a 39 years old male. Thyroid cancer is found in ~5% of thyroid nodules, so the vast majority are benign (noncancerous). Molecular Markers: genes and microRNAs that are expressed in benign or cancerous cells. My blood tests came back totally normal and I am totally asymptomatic. 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. An official website of the United States government. Used for FNA indeterminate nodules (bethesda III-IV). It was .62cm by then. The doctor is an Endocrine Surgeon that specializes in Thyroid/Parathyroid and Adrenal surgeries. THE FULL ARTICLE TITLE: -No Size changes of Nodule in last 2-3 months (duration of time to get all of these tests) 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 . After some research of my own, I decided to leave it. The original Afirma gene test was a gene expression classifier (GEC) that used a technology called a microarray that results in a pattern of gene expression. Frontiers | Thyroseq v3, Afirma GSC, and microRNA Panels Versus government site. I did not get to go under the knife for my TT til this past March. -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 The rest were called benign by the GEC. Are you sure you want to block this member? 2016 Wiley Periodicals, Inc. Keywords: The doc mentioned the thyroid and upon a physical exam felt the nodule, leading to the rest of the testing. Several thyroid nodules. I have multiple nodules. 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. Found an endocrinologist who is willing to work with me on some more testing. (although it is so small, you can see it in my neck). 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'm now 3 days post op and other than some difficulty swallowing and talking loud, I'm feeling great. It is illegal for auto mechanics to do work on our car without an estimate, or accountants, lawyers etc but doctors and medical facilities can just run us into BK without any regard. Cytopathol. suspicious - ~50% risk of cancer. Afirma result was suspicious in 69 cases. I understand that Afirma tends to have a lot of false positives, but it's supposed to be fairly accurate for negative results. And he said he doesn't think the Afirma test is as accurate as they say. 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. Patients usually return home or to work after the biopsy without any ill effects. Background: I am very resistant to the thought of having a gland removed that is functioning perfectly fine, if it isn't cancer. Sometimes you only hear the bad stories and not the good so I wanted to share mine. Have lots of decisions to make and just trying to do some homework. Genes: a molecular unit of heredity of a living organism. This was done in hopes of maintaining my own thryoid function which the doctors and I felt better than taking thyroid medicine daily for the rest of my life. Background: The Afirma Gene Expression Classifier (GEC) has been used to further characterize cytologically indeterminate (cyto-I) thyroid nodules into either benign or suspicious categories. My thyroid nodule (1.5 cm) was discovered by mistake; the technician was only supposed to do an ultrasound on my gallbladder and ovaries, but for some reason did my thyroid as well. 1. Home Patients Portal Clinical Thyroidology for the Public October 2016 Vol 9 Issue 10 p.11-12, CLINICAL THYROIDOLOGY FOR THE PUBLIC Then she tells me she's just had a "bad feeling" about my case from the beginning, and she wants me to have a TT soon. And it keeps growing. 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. Cancer-Associated Genes: these are genes that are normally expressed in cells. (Afirma GSC suspicious, suspicious for malignancy, or malignant cytopathology) ,2,4,8 the GSC is to further differentiate indeterminate FNA. 3.) Local surgical pathology diagnoses were available for 11 of these nodules. The moment that I've been so nervous about finally came yesterday. Historically, most patients with indeterminate thyroid nodule biopsies were referred for surgery though most would ultimately not have thyroid cancer (around 75% or more would have an unnecessary surgery). So frustrating!! The Afirma Xpression Atlas for thyroid nodules and thyroid cancer They sent me home with 125mcg of Synthroid, calcitrol, and calcium. 85% were benign. However, I was not informed of this. I could feel food getting lodged in my throat, and felt a pinch like a nerve at times, too. What have been your experinces with AFIRMA? Endo M et al 2019 Afirma Gene Sequencing Classifier compared with Gene Expression Classifier in indeterminate thyroid nodules. And she said her surgeon said that this test is not very reliable and that meanwhile she has a large bill from the company. 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. Others understand my need for more information.