afirma gsc suspicious 50

Until now, Afirma has been available as two tests: Afirma GSC and Afirma Xpression Atlas (XA). I opted to have the TT and it turned out it was cancerous and had spread to a few lymph nodes, so then I had right and left central neck dissections as well. I am so new to all this that I don't know what this means. How they found it was my complaint of feeling tired all the time. My surgeon and endocrinologist said no further treatment is needed but to continue observation. I hope this helps calm some fears for others who may be going through the same thing. Thyroid cancer is found in ~5% of thyroid nodules, so the vast majority are benign (noncancerous). Cancer Cytopathol. Mild lymphocytic thyroiditis ( nonspecific) Results: Since that time, the pain has all subsided -- I think the biopsy just roughed things up, but when they calmed down, I felt no pain whatsoever, again. All my blood tests and tsh levels are in the normal range. Otolaryngol Head Neck Surg. The Afirma MTC may not be billed separately using an additional unit or procedure code. She admitted once she thinks cancer is unlikely. GEC's SE and SP among studies ranged from 78.0 to 100% and 7.7 to 51.7%, respectively. Thus, 54 NIFTP cases were established, all with a suspicious Afirma GEC result. 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. I had a biopsy for 4 nodules 2 mos ago. Thanks so much! Afirma BRAF V600E o Afirma BRAF testing may be considered for either GSC or FNA suspicious or malignant results. Thyroid Fine Needle Aspiration Biopsy (FNAB): Change In Thyroid Nodule Volume Calculator, Find an Endocrinology Thyroid Specialist, Clinical Thyroidology for the Public (CTFP). Should I be treating this as a Hurthle Cell Lesion, or should I just relax. 2) Partial or Total Thyroidectomy? I posted the below post on this forum on several different topics since 2013. Conclusion: 4. Treatment like a cytologically benign nodule may be appropriate, including clinical correlation. Indeterminate thyroid nodules in the era of molecular genomics. Our new findings show that the real-world experience supports this data, further demonstrating that the likelihood of malignancy in Afirma GSC-suspicious nodules is even greater than what was . Follicular and hurthle cells are normal cells found in the thyroid. Yesterday my surgeon told me that FNA Biopsy and Affirma are not reliable and said he would be surprised if the post op pathology shows the same findings. After reading many stories, I didn't know what to expect. How should I proceed with these results? Cancer cells frequently have mutations in these genes. He also said that what the Afirma pathologist and representatives told me that I have a 40% suspicious chance of thyroid cancer isn't true.He said it's about 25% still. No parathyroid tissue identified. Several thyroid nodules. Is is the Benign that is a false negative ? However, that information will still be included in details such as numbers of replies. 4,6 In addition to the benign versus malignant classifier, the Afirma GSC suite includes No one was telling me that. https://www.inspire.com/groups/thyca-thyroid-cancer-survivors-association/discussion/need-advice-surgery-or-not-based-on-40-afirma-test/?page=2#replies. I welcome your thoughts on my case. There are 3 variants of papillary thyroid cancer: classic, follicular and tall-cell. For those of you that had a thyroidectomy, how long did it take for you to realize that the medicine was or was not enough for you? Like I said I'm doing ok and compared to what I see about the aftermath of having my thyroid removed, I sometimes just want to leave it alone and keep an eye on it instead. official website and that any information you provide is encrypted He recently called me back and said that my criticism of the test is valid. At this point, I was exasperated by all of the running around, but fine. Follicular Neoplasm. They call follicular neoplasms with hurthle cells FNOF. A. My surgeon wants to operate right away stating that these kind of results have a 90% truancy for cancer to be present. Maternal side history of goiter in females, no known thyroid cancer, but late breast cancer and colon cancer It seems like with every ultrasound, some new suspicious characteristic pops up. Disclaimer. Patients usually return home or to work after the biopsy without any ill effects. On cytologic evaluation 3.0% of the cases were non diagnostic (ND), 9% benign, 62% AUS, and 26% suspicious for neoplasm (SN). One of these women member dacooper12 on Inspire in their ThyCa forum had the opposite result,which the studies show,that the Afirma test misclassifies a much smaller % of cancerous nodules as benign compared to the higher % of benign nodules it misclassifies as "suspicious. Please click on this link below about the woman with a 1-1 and half cm solid hypoechoic nodule who had an inconclusive Fine Needle biopsy which was suspicious as a follicular neoplasm and mine is being called a follicular neoplasm with oncocytic (hurthle cell features) ,this woman had her FNA nodule sample tested by the veractye Afirma Test which is what I had done,the results came back telling her that her that their results on her FNA was highly suspicious and that because of this her endo told her she had an 80% chance of having thyroid cancer and so she had her thyroid out and found out it was benign! The remaining 18% were malignant. 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. Have lots of decisions to make and just trying to do some homework. How could it be Benign on one side and Suspicious on the other ? Afirma testing is back "Risk of malignancy: Afirma GSC Suspicious ~50%" "Malignancy classifiers: Negative" "MTC and BRAF classifier results were negative and RET/PTC1 and RET/PTC3 were not detected. What was your experience? A group of expert pathologists have recently identified a subgroup of papillary thyroid cancer called noninvasive follicular variant papillary thyroid cancer that has a very low risk of relapsing after surgical removal. 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!) She didn't seem overly concerned based on all my previous records. He said this Afirma test is wrong half the time misclassifying benign nodules as suspicious,(I'm sure it's even more than half!) The .gov means its official. 2016 Wiley Periodicals, Inc. Keywords: Paratracheal nodule (inclduing B1FS): Thyroid Parenchyma, negative for tumor. 6. What have been your experinces with AFIRMA? 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. Sometimes you only hear the bad stories and not the good so I wanted to share mine. No lymphovascular invasion is identified. Hello, I was told that my thyroid needs to be removed (at least half, possibly all). 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. 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% http://www.thyroidboards.com/showthread.php? -Male - Slightly Hypothyroid which began over the past year or so But all of these suspicious ultrasound results have me wondering if I might have gotten a false negative on the Afirma. 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. I almost want to cancel the surgery. All I can say is that in reviewing my ultrasounds and the report from the interventional radiologist and the Affirma report, I have noticed that there are inconsistencies in even the reported measurements of the nodules and now that I have read further into studies done on people undergoing thyroid removal after getting "Suspicious"/40% of Cancer Affirma results, there are many more false positives than Afirma would have you understand. 2021 Apr;10(2):168-173. doi: 10.1159/000509037. 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 . The biopsy (Afirma) was indeterminate with GSC suspicious with a 50% ROM. Arma XA is not performed on GSC Benign nodules.7 IIIIV Atypia of Undetermined Signicance Therefore, a new version of the Afirma test was created called a gene sequencing classifier (GSC) to better predict thyroid cancers in indeterminate nodule while still being able to rule out cancer in benign nodules. 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. Thanks again, Ok so this is all brand new to me so please bear with me. Just had TT yesterday. I was seen by a thryoid surgeon who did a 1st biopsy with w/ " suspicious of FVPTC". A 36% Increase in Specificity With Afirma GSC Versus Older Test . Dincer N, Balci S, Yazgan A, Guney G, Ersoy R, Cakir B, Guler G. Cytopathology. So the probabilities of malignancy for the various Bethesda risk categories are going to change. A woman on the excellent health site Medhelp told me she had a 3cm. -Afirma Test: "Suspicious for Malignancy" - NEGATIVE for BRAF, MTC, RET/PTC1 and RET/PTC3 The Affirma Genomic Sequence Classifier (GSC) is based on DNA sequencing. Sometimes, thyroid biopsy specimens are indeterminate, meaning that thyroid cancer cannot be definitively ruled in or out. 2020 Sep;8(9):e1288. The positive predictive value of the GSC is 47.1%.1 Results Afirma GSC results may help guide surgical decision making in patients with thyroid nodules. Did your Afirma results show calcification? 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. 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! The Afirma Genomic Sequencing Classifier (GSC) provides physicians with a comprehensive solution for a complex landscape in thyroid cancer diagnosis and individualization of care. I have found this community very informative, thank you. It's barely even hoarse. The surgeon was great. 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. 1. While most thyroid nodules are non-cancerous (Benign), ~5-10% are cancerous. However the "suspicious" result of the Afirma GEC does not classify these indeterminate nodules further in determining appropriate management. I refuse to rush as there are long-term consequences either way. My question is then I guess, is it really that bad afterwards managing levels and the other side effects post TT? 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. Afirma said NEGATIVE for BRAF and Meduliary but still assigned a classification of "Suspicious" with 40% chance of cancer. The cells need to be "fresh." 2017 May;125(5):313-322. doi: 10.1002/cncy.21827. detect variants in greater than 50 genes. My Enfo bumped up my Synthroid right away to adjust for the surgery. I know, that is still pricey but seems cheap compared to $6,000. Thoughts or experiences?? I have made an appointment with another endocrinologist, but just to talk to him. 1). We had a long talk and discussed more conservative options, like a partial thyroidectomy, but no rush. Patients with thyroid nodule biopsies with indeterminate cytology results were chosen for additional genetic testing; the Afirma GEC (during the period February 2, 2011July 11, 2017) or the Afirma GSC (during the period July 11, 2017December 19, 2018). 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 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. o The Afirma MTC testing must be billed as part of the Afirma GSC. Once you go down the hole, there are no good statistics to guide you in making rational decisions in an irrational area of medicine - AND as you know, no decisions in medicine in even cut and dried cases are so simple as to have no opposing point of view. 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. Everyone's story and experience seemed to be totally different. Hello, new here and confused, anxious and a bit worried. The Afirma Genomic Sequencing Classifier (GSC) classifies cytologically indeterminate thyroid nodules as molecularly benign or suspicious. Epub 2021 Jun 22. Another problem with Afirma is that pretty soon they are going to have to adjust the test to the reclassification of non-invasive FVPTC. THE FULL ARTICLE TITLE: B. 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. I had my surgery in NYC, it took 2 hours, and I went home the same day. So far, no problems with calcium. Used for FNA suspicious nodules (bethesda V-VI) or nodules deemed suspicious by the GSC classifier. These results do not change the risk of malignancy of the (ROM) of the Afirma GSC suspicious result." Right now my neck lymph nodes look good. They were incredibly supportive and also concerned. Hi, I am joining this group because I was recommended surgery.. doi: 10.1002/mgg3.1288. I wish you luck in whatever you decide. Here are some results/Info: She says very little, and if she does say anything, questions my reactions. National Library of Medicine 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! Thyroid nodule: an abnormal growth of thyroid cells that forms a lump within the thyroid. But that's a personal issue I'll have to work out in time. I don't know if I'm speaking too soon, but the pain isn't as bad as I thought it would be. I have slightly high blood pressure and slightly high cholesterol that are well controlled with meds. Of the 164 GSC nodules, 29 (17.6%) underwent thyroid surgery. Used for FNA indeterminate nodules (bethesda III-IV). This is about 25% of all thyroid cancers currently. 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. . Please, I am looking for any and all thoughts. 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. Afirma GSC (NOT GEC) 50% Suspicious Fayadosky Oct 30, 2018 10:56 AM (edited Nov 04) Results came back 50% Suspicious for FN (Follicular Neoplasm) with positive HRAS c.18HRAS c.182A>G (Q61R) Negative for BRAF, RET/ptc1 and ptc3 Any Insights? However, its relatively low positive predictive value (PPV) limited its use as a classifier for patients with suspicious results. Accessibility Thanks. 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 results of the GEC are either read as suspicious for cancer or benign. Thyroid nodules are commonly found on ultrasound of the neck and the evaluation of a thyroid nodule may include thyroid biopsy. Here n this 2014 discussion member Olivia-T who was 69 when she posted this and had hurthle cell neoplasm that tripled in size in 10 months,and got a 40% suspicious from the Afirma test,and did post a follow up that did turn out to have thyroid cancer,says here that her oncologist said that her last two patients who had surgery also because of the 40% suspicious for cancer DNA test turned out to have benign tumors. Noninvasive follicular variant of papillary thyroid carcinoma and the Afirma gene-expression classifier. In such cases, testing of molecular markers related to thyroid cancer may help determine the risk of cancer. Neither will talk to the other. One has tested benign on several FNAs, is cystic, and has remained consistent in size. I'd done enough research to know that Thyroid cancer is generally treatable, and was sure to tell them about that. The doctor uses a very thin needle to withdraw cells from the thyroid nodule. Negative for BRAF, RET/ptc1 and ptc3 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. My blood tests came back totally normal and I am totally asymptomatic. With these genetic tests, patients and physicians have more information to feel confident about avoiding surgery or pursuing it based on the test results. Patient medical records were retrospectively reviewed for clinical history, FNA results, radiologic findings, management and follow-up. Ultrasound reports unfortunately not very informative other than size. 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.". It was .62cm by then. I'm not against surgery if needed, but wondering shouldn't it be followed for a bit before such a drastic measure is taken. I had numerous FNA biospy's last result "suspicious for follicular neoplasm " , the last ultrasound showed several microcalcifications on left and scattered microcalcification on the right. I had a total thyroidectomy in NYC. 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 Here is what the Affirma test disclaimer said: Benign: Preformance characteristics not defined for nodules less than 1 cm diameter. 2021 May 13;12:649522. doi: 10.3389/fendo.2021.649522. On cytologic evaluation 3.0% of the cases were non diagnostic (ND), 9% benign, 62% AUS, and 26% suspicious for neoplasm (SN). But, I am concerned about the report I just received. Now, I will most probably undergo surgery, I requested only the right side be removed and they will have a pathologist look at it while I am under and then decide if they remove the whole thing. They incidentally found a nodule on my right thyroid tru CTSCAN in Dec.2014. Others understand my need for more information. 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. 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. Choosing to have the surgery was the most difficult decision ever, since I wasn't sure if my nodule was cancerous or not, and of course I didn't want to go through the surgery all for nothing. Molecular markers can be used in thyroid biopsy specimens to either to diagnose cancer or to determine that the nodule is benign. Only when I had a follow up visit with a cardiologist in JAn.of 2016 he noticed the results after requesting the previous scan results. Federal government websites often end in .gov or .mil. An official website of the United States government. 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. First off, I understand about 25% of suspicious actually turn out to be cancer (not that I should just "roll the dice") Wow! The https:// ensures that you are connecting to the The Afirma test results came back Benign on left side and Suspicious 40% on the right side . I don't trust this new Afirma thyroid test for very good reasons. I am still holding off on surgery for now. The overall PPV of an Afirma GSC suspicious nodule was 47%, regardless of variant/fusion status. Among the 22 with only a TP53 alteration, the first 16 consecutive nodules were included (7 nodules were Bethesda III and 9 nodules were Bethesda IV). Any Insights? This did not surprise me since I had researched "suspicious." The third biopsy was sent for genetic testing which came back as suspicious. - Partial was recommended at first, though we are leaning total now with the remainder of tests now complete. 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. 2. I've enjoyed good health for my whole life. False positive rate of Afirma was 56% (32/57). BACKGROUND 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. Later that week I received a call telling me it was suspicious and was referred to an ENT which I saw yesterday. Before Good luck and happy thoughts! Molecular testing for indeterminate thyroid nodules: Performance of the Afirma gene expression classifier and ThyroSeq panel. I find out my biopsy results next week. Neither will talk to the other. Have lots of decisions to make and just trying to do some homework. These 3 papers report the performance of these assays in evaluating Bethesda III and IV indeterminate biopsies. He wisely advised that I need a thyroid ultrasound which revealed the nodule had grown to 2.2cm. Genes hold the information to build and maintain an organisms cells and pass genetic traits to offspring. I am also concerned about hormone replacement, would like some personnal comments on recovery from Lobectomy versus TT . And she's just mostly silent about it. Each wait has been tough, but the wait after the biopsy was excruciating. Epub 2020 Aug 6. Long-Term Outcomes of Thyroid Nodule AFIRMA GEC Testing and Literature Review: An Institutional Experience. Careers. undefined will no longer be visible to you including posts, replies, and photos. The Afirma GSC is designed to help clinicians manage these patients. I've read a lot about this test (both good and bad). I am scheduled to have a TT on March 9th and I wish I felt a little better about my decision. One > 2cm, undetermined twice and "suspicious for follicular neoplasm" the most recent FNA Polavarapu P, Fingeret A, Yuil-Valdes A, Olson D, Patel A, Shivaswamy V, Matthias TD, Goldner W. J Endocr Soc. Afirma GEC or GSC a gene-expression classifier that identifies biopsies as "benign" or "suspicious," and mir-THYtype an mRNA-based classifier test. (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.) Afirma GSC is a pre-operative genomic test for thyroid tumor biopsies that have . (And myself.) I know how frustrating, scary and expensive this whole process is.I am sorry that you are going through it!! Thyroid cancer support group and discussion community. Epub 2017 Feb 2. 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!)

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