afirma gsc suspicious 50

I have slightly high blood pressure and slightly high cholesterol that are well controlled with meds. At this point, I was exasperated by all of the running around, but fine. A month ago I had the Afirma test and it came back positive - suspicious for cancer which increased my chance from 5% to 50%. 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.". 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). 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. Please Help! Largest is 2.3(previously 1.8cm in 2014) different test center though. 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. I called and almost everyone has that risk if it is suspicious. 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. 2021 May 13;12:649522. doi: 10.3389/fendo.2021.649522. Clinician should therefore exercise caution in using this result for treatment decisions. Any help really will be appreciated. Thyroid nodule: an abnormal growth of thyroid cells that forms a lump within the thyroid. PMC Noninvasive follicular variant of papillary thyroid carcinoma and the Afirma gene-expression classifier. Thyroid nodules are commonly found on ultrasound of the neck and the evaluation of a thyroid nodule may include thyroid biopsy. -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 Follicular and hurthle cells are normal cells found in the thyroid. The Afirma GSC is a cancer rule-out test with a high negative predictive value so that cytologically indeter-minate (Bethesda III/IV)2 thyroid nodules with an Afirma GSC benign result can be considered for clinical observation in lieu of diagnostic surgical resection (Fig. This did not surprise me since I had researched "suspicious." Thanks. t=5283], http://www.thyroidboards.com/showthread.php? However, that information will still be included in details such as numbers of replies. This nodule is solid, hypoechoic, increased central vascularity and now possible microcalcification. Don't get me wrong, it hurts, but I'm able to swallow (soft foods) and talk ok. Nishino M, Mateo R, Kilim H, Feldman A, Elliott A, Shen C, Hasselgren PO, Wang H, Hartzband P, Hennessey JV. 5) What are your thoughts on these results? However, its relatively low positive predictive value (PPV) limited its use as a classifier for patients with suspicious results. 4) How do I make sure I get the best care? It's really upsetting to suddenly be thrust into this with no symptoms, etc. This is about 25% of all thyroid cancers currently. https://www.inspire.com/groups/thyca-thyroid-cancer-survivors-association/discussion/need-advice-surgery-or-not-based-on-40-afirma-test/?page=2#replies. 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. Complex nodule. Each wait has been tough, but the wait after the biopsy was excruciating. https://www.inspire.com/groups/thyca-thyroid-cancer-survivors-association/discussion/genetic-test-two-different-results/reply/6888430/?msg_activity=reply_posted. I'm fearful this is a Hurthle Cell Lesion, and I do not like what I have read. It took about 8 days to get back results. The current Afirma Genomic Sequencing Classifier (GSC) demonstrates improved specificity, suggesting more nodules will have a benign result (benign call rate [BCR]), but independent data are needed to confirm this in clinical practice. It just really annoys me that doctors can order tests that cost us money without our consent. Epub 2017 Feb 2. 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. WHAT ARE THE IMPLICATIONS OF THIS STUDY? Please, I am looking for any and all thoughts. I've read a lot about this test (both good and bad). Unauthorized use of these marks is strictly prohibited. Local surgical pathology diagnoses were available for 11 of these nodules. Molecular markers can be used in thyroid biopsy specimens to either to diagnose cancer or to determine that the nodule is benign. Here's what a friend of mine wrote who is a retired neurologist: "They can both be right for different reasons, or from different perspectives. These results do not change the risk of malignancy of the (ROM) of the Afirma GSC suspicious result." Epub 2012 Oct 18. Thyroid 29:11151124. 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. 8600 Rockville Pike Since then, I've had yearly scans (ultrasounds) and two biopsies, both came back negative. Well, this last spring my endo said she didn't like my latest ultrasound results. 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]). ThyCa: Thyroid Cancer Survivors' Association, Inc. 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! The results were suspicious of papillary cancer, but not conclusive. The rate of malignancy in nodules suspicious for neoplasm (SN) on cytology interpretation was 31.2% (5/16). I am still holding off on surgery for now. 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! 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. Otolaryngol Head Neck Surg. Of the 16 cases of follicular variant papillary thyroid cancer, 14 of them were noninvasive follicular variant of papillary thyroid cancer (88%). SUMMARY OF THE STUDY BTW, I'm about to turn 50 and I have no thyroid issues other than this. 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 . Of the 343 nodules that underwent the GEC test, 178 cases (51.9%) were considered suspicious for cancer. This all new to me and I have a lot to learn. 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! Everyone's story and experience seemed to be totally different. Just had TT yesterday. I really hope that a much better,much more accurate reliable test like this will be created! 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 CANCER Thanks so much! Currently, gene tests can provide more information as to whether an indeterminate nodule is a cancer or not. Thus, 54 NIFTP cases were established, all with a suspicious Afirma GEC result. The remaining 18% were malignant. I have made an appointment with another endocrinologist, but just to talk to him. http://www.glandsurgery.org/article/view/1002/1193. Which means I would still be paying this amount to the hospital if I didn't pay it to Affirma. The moment that I've been so nervous about finally came yesterday. 5. I'm not sure what the exact terminology is going to be. Then in December 2014 I thought to have it checked again, with the same results although this time I had it send for the Afirma testing which I was told is more accurate test for cancer. How Does the Afirma Genomic Test Perform in the Real World? Hi, I am joining this group because I was recommended surgery.. I was just feeling so much weight and defeated as a mother of four small children..three biological and one adopted in 2012..could not phantom the idea of not being there for my kids esp. The mindset of medical doctors is to analyze the information at hand and see if anything changes that warrants getting more data or doing surgery.". I am not afraid of the surgery, only would really be disapointed if a vital organ was removed from my body for nothing. 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. 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. While most thyroid nodules are non-cancerous (Benign), ~5-10% are cancerous. National Library of Medicine I'm determined to eek out the positive in this. Should I be treating this as a Hurthle Cell Lesion, or should I just relax. 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. Am I being reasonable? Can someone give me their take on my fna results? I immediately started crying, knowing that a phone call wasn't "the good news." The Afirma Xpression Atlas for thyroid nodules and thyroid cancer On cytologic evaluation 3.0% of the cases were non diagnostic (ND), 9% benign, 62% AUS, and 26% suspicious for neoplasm (SN). 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% In such cases, testing of molecular markers related to thyroid cancer may help determine the risk of cancer. Thyroseq v3, Afirma GSC, and microRNA Panels Versus Previous Molecular Tests in the Preoperative Diagnosis of Indeterminate Thyroid Nodules: A Systematic Review and Meta-Analysis. WHAT ARE THE IMPLICATIONS OF THIS STUDY? They were incredibly supportive and also concerned. Disclaimer. Federal government websites often end in .gov or .mil. My surgeon and endocrinologist said no further treatment is needed but to continue observation. I had my surgery in NYC, it took 2 hours, and I went home the same day. Performance of Afirma Gene Sequencing Classifier versus - ScienceDirect 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.

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