afirma gsc suspicious 50

So frustrating!! Christmas got in the way, so January 22 is my date. The final Diagnosis from Mayo Clinic: 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. But still my labs are all within normal range. A month ago I had the Afirma test and it came back positive - suspicious for cancer which increased my chance from 5% to 50%. 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. Local surgical pathology diagnoses were available for 11 of these nodules. 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. Thyroid nodule: an abnormal growth of thyroid cells that forms a lump within the thyroid. Gorshtein A, Slutzky-Shraga I, Robenshtok E, Benbassat C, Hirsch D. Eur Thyroid J. How do Afirma GSC & Xpression Atlas tests work? What do they mean The pathology database was searched for all thyroid nodules with Afirma test results over a three year period, 2013-2015. Papillary thyroid cancer is the most common type of thyroid cancer. I was told to monitor my nodules every couple years using ultra-sound and if they increased in size, they needed to have FNA done. Here is what the Affirma test disclaimer said: Benign: Preformance characteristics not defined for nodules less than 1 cm diameter. 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. I don't want to jump the gun, and will wait to hear what the new doctor says. My question is then I guess, is it really that bad afterwards managing levels and the other side effects post TT? 4) How do I make sure I get the best care? Mild lymphocytic thyroiditis ( nonspecific) As I have learned on this board, just 'taking a pill' for the rest of your life isn't as easy as it sounds. 2021 Aug;31(8):1253-1263. doi: 10.1089/thy.2020.0969. Part 3: Afirma genetic testing for thyroid cancer - Running with a 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. Thank you. Molecular testing for indeterminate thyroid nodules: Performance of the Afirma gene expression classifier and ThyroSeq panel. Cancer cells frequently have mutations in these genes. Upenn top thyroid pathologists including Dr.Virginia Lavosi report that follicular neoplasms with oncocytic (hurthle cells)often are misclassified as suspicious by the Afirma test! The third biopsy was sent for genetic testing which came back as suspicious. I called and almost everyone has that risk if it is suspicious. I knew it was not good news. 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. Thyroid 2016;26:911-5. 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. In my opinion, and my surgeons, I think FNA and Affirma are only good tools if you have positive results. Arma XA is not performed on GSC Benign nodules.7 IIIIV Atypia of Undetermined Signicance malignant - The chance of cancer is very high >99% malignancy, surgery is necessary. Just underwent Afirma and Asurgen testing on the suspicious 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. Would you like email updates of new search results? Patients usually return home or to work after the biopsy without any ill effects. Epub 2020 Aug 6. National Library of Medicine 5. :-). Competition Heats Up With Latest Tests for Thyroid Nodules Comparison of Afirma GEC and GSC to Nodules Without Molecular Testing in Cytologically Indeterminate Thyroid Nodules. Fingers crossed they come back negative for cancer! After reading many stories, I didn't know what to expect. The Afirma GEC is a microarray-based molecular test that uses a machine learning-derived classification algorithm to further classify indeterminate thyroid nodules into benign and suspicious categories. they misclassify benign nodules as suspicious! In such cases, testing of molecular markers related to thyroid cancer may help determine the risk of cancer. It is unclear whether mutations in these genes cause the cancer or are just associated with the cancer cells. 2017 May;125(5):313-322. doi: 10.1002/cncy.21827. The rest were called benign by the GEC. I refuse to rush as there are long-term consequences either way. The surgeon recommended complete removal of my thyroid. -Afirma Test: "Suspicious for Malignancy" - NEGATIVE for BRAF, MTC, RET/PTC1 and RET/PTC3 Results: Thirty-eight TP53 variants were present among >13,000 Bethesda III/IV Afirma GSC Suspicious samples. You cannot become a thyroid cancer specialist in 24 hours needless to say. Euphemia I just read your post about classifications changing. 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 were suspicious of papillary cancer, but not conclusive. ThyCa: Thyroid Cancer Survivors' Association, Inc. The Afirma Xpression Atlas for thyroid nodules and thyroid cancer Ultrasound reports unfortunately not very informative other than size. and transmitted securely. There are 3 variants of papillary thyroid cancer: classic, follicular and tall-cell. Polavarapu P, Fingeret A, Yuil-Valdes A, Olson D, Patel A, Shivaswamy V, Matthias TD, Goldner W. J Endocr Soc. 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. The Xpression Atlas reports 905 genomic variants and 235 fusion pairs on GSC Suspicious, Suspicious for Malignancy (SFM), and Malignant FNA samples at the time of diagnosis. 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 . t=5283], http://www.thyroidboards.com/showthread.php? -38yrs old I did not get to go under the knife for my TT til this past March. 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. The Afirma gene sequencing classifier (GSC) performs better in indeterminate thyroid nodules than the Afirma gene expression classifier (GEC). So I was reading about the new kind of fna biopsy called Afirma, and I guess that my question is, is it worth getting it as a second opinion or should I go through with the surgery because of the results not being undetermined. This isn't saying that Afirma's test isn't useful. So far, no problems with calcium. Each of my pre-surgical tests are pointing more and more in the wrong direction. I'm ready for my next step. 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 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 The range of confirmed cancer (post surgery) from different studies was as low as 17% to as high as close to 50%. Afirma result was suspicious in 69 cases. 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. She admitted once she thinks cancer is unlikely. The Affirma Xpression Atlas is based on RNA sequencing. I know how frustrating, scary and expensive this whole process is.I am sorry that you are going through it!! BACKGROUND Repeat Fine Needle Aspiration Cytology Refines the Selection of Thyroid Nodules for Afirma Gene Expression Classifier Testing. result (eg, benign or suspicious) Public Comment. Right now my neck lymph nodes look good. 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. 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 . Largest is 2.3(previously 1.8cm in 2014) different test center though. 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. 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! Until now, Afirma has been available as two tests: Afirma GSC and Afirma Xpression Atlas (XA). Good luck and happy thoughts! 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. Am I being reasonable? Two have been tested by FNA multiple times over 5 years Lastly I do 25mcg of levothyroxine once a day for Hypothyroidism, it was prescribed based on lab results, not on how I was feeling. If all nonsurgical GSC benign cases were truly benign, the chance a suspicious nodule was truly a thyroid cancer was 60% and a benign nodule was benign was 100%. 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. Unauthorized use of these marks is strictly prohibited. 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! Cancer Cytopathol. Sometimes, thyroid biopsy specimens are indeterminate, meaning that thyroid cancer cannot be definitively ruled in or out. While most thyroid nodules are non-cancerous (Benign), ~5% are cancerous.
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