MeSH 2017;45:308-311. 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. result (eg, benign or suspicious) Public Comment. Clinician should therefore exercise caution in using this result for treatment decisions. 85% were benign. However, the interesting twist was that cancer was not detected on the nodules being monitored, there was a little sucker hidden behind all these years according to my surgeon and this was why the pathologist at my local hosp could not come up with definitive conclusion as he/she was only focused on the biopsied nodules:( He recently emailed me back and said,as we discusssed on the phone,he agrees with many of my concerns about the Afirma test. Thyroid fine needle aspiration biopsy: a simple procedure that is done in the doctors office to determine if a thyroid nodule is benign (non-cancerous) or cancer. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Papillary thyroid carcinoma, Follicular Variant, 2.1 cm in greatest dimension, present in mid to lowe pole, woth prior FNA site changes. The Afirma MTC may not be billed separately using an additional unit or procedure code. Mild lymphocytic thyroiditis ( nonspecific) An evaluation of the molecular marker tests for thyroid cancer When the nurse called she couldn't even tell me results over he phone -- she said she didn't know them -- but set up an appointment for end of the following week -- another wait. Thyroid Fine Needle Aspiration Biopsy (FNAB): Change In Thyroid Nodule Volume Calculator, Find an Endocrinology Thyroid Specialist, Clinical Thyroidology for the Public (CTFP). I think my biggest problem is what I read on the internet as far as all the problems afterwards. 2017 May;125(5):313-322. doi: 10.1002/cncy.21827. So, what do I not know? 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. Just underwent Afirma and Asurgen testing on the suspicious one. Results: Will find out results in about a week. There are 3 variants of papillary thyroid cancer: classic, follicular and tall-cell. A thyroid nodule biopsy can be benign (normal), malignant (cancer) or indeterminate. :-). My doctor then sent me to an endocrinologist for a biopsy which came back with atypical but inconclusive results. Noninvasive Follicular Variant of Papillary Thyroid Carcinoma and the Afirma Gene-Expression Classifier. If benign = no surgery, IF suspicious or malignant = surgery. They did not address that issue in their letter, just my income. Overall malignancy rates were highest in the GSC group at 39%, compared to 20% and 22% in the no-molecular-testing and GEC groups, respectively (P = 0.0222) . Surgical margins: negative for tumor (tumor is < 0.1cm from margin) 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. 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). - Partial was recommended at first, though we are leaning total now with the remainder of tests now complete. I'm a 39 years old male. 2020 Sep;8(9):e1288. So I thought I was in the clear, and decided to just monitor this nodule for growth, and revisit the surgery idea only if size became an issue. Follicular and hurthle cells are normal cells found in the thyroid. The doctor is an Endocrine Surgeon that specializes in Thyroid/Parathyroid and Adrenal surgeries. 2021 Aug;31(8):1253-1263. doi: 10.1089/thy.2020.0969. He said there was no lymph node involvement but there's no way to tell until final path. Thyroid nodule molecular profiling: The clinical utility of Afirma 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. There are risks and benefits to any decision - and humans are very bad at assessing both. I'm curious, if you had similar biopsy results and had surgery, was your final path malignant or not? 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). In this discussion of the Afirma test from 2013 on this board several people also had false results from the Afirma test all false suspicious except for the first, reply from member dacooper12 who said that the Afirma test said her nodule was benign but later she had her thyroid removed and found out that it was actually pap cancer that spread into her central lymph node. Here member santef1 says she had a 2cm nodule that came as suspicious from the Afirma test but after surgery that nodule was found to be benign but as with what happened to so many people,they found several micro pap cancers not seen on the ultrasound. The https:// ensures that you are connecting to the For one thing, I had some pain on one side after biopsy. Noninvasive follicular variant of papillary thyroid carcinoma and the Afirma gene-expression classifier. Silaghi CA, Lozovanu V, Georgescu CE, Georgescu RD, Susman S, Nsui BA, Dobrean A, Silaghi H. Front Endocrinol (Lausanne). A publication of the American Thyroid Association, Suspicious readings of the Afirma gene-expression classifier include some noninvasive encapsulated follicular variant of papillary thyroid carcinomas. It's barely even hoarse. 2) Partial or Total Thyroidectomy? Otolaryngol Head Neck Surg. sharing sensitive information, make sure youre on a federal Cancer Cytopathol. He tried to console me but he was also upset. Personally, I think getting the AFIRMA test done is a good thing. You cannot become a thyroid cancer specialist in 24 hours needless to say. Euphemia I just read your post about classifications changing. NTRK, RET, BRAF, and ALK fusions in thyroid fine-needle aspirates (FNAs). I have slightly high blood pressure and slightly high cholesterol that are well controlled with meds. 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. In my opinion, and my surgeons, I think FNA and Affirma are only good tools if you have positive results. It took about 8 days to get back results. So now I feel I have no choice to take it out (the nodule also grew .5 cm since the Aug test). Of the 164 nodules included in the study with the GSC test, suspicious nodules were found in 39 of the 164 nodules (23.7%). Each wait has been tough, but the wait after the biopsy was excruciating. Any Insights? How they found it was my complaint of feeling tired all the time. The authors concluded that a GEC suspicious test result may include noninvasive follicular variant papillary thyroid cancer as well as classical papillary thyroid cancer. Competition Heats Up With Latest Tests for Thyroid Nodules Evaluation of the Afirma Gene Expression Classifier to determine and transmitted securely. The Afirma gene sequencing classifier (GSC) performs better in My surgeon wants to operate right away stating that these kind of results have a 90% truancy for cancer to be present. Thyroid nodule: an abnormal growth of thyroid cells that forms a lump within the thyroid. Any help really will be appreciated. And she's just mostly silent about it. See Somatic Mutation Testing - Solid Tumors guideline for criteria. What was your experience? The aim of this study was to determine the clinical performance of the GSC as compared with the GEC at one academic medical center. Frontiers | Thyroseq v3, Afirma GSC, and microRNA Panels Versus 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. 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! PDF Summary of Veracyte Recommendations - CMS For nodules determined to be GSC Suspicious or with a cytopathology diagnosis of Bethesda V or VI, physicians ordered XA by checking a box. Forth, I have absolutely no symptoms and feel fine. An important limitation of this study is that the authors did not examine the rate of noninvasive follicular variant papillary thyroid cancer in specimens that were not reported as suspicious by the GEC test.