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thyroid solid nodule
hello I have solid thyroid nodule i`ve done blood test and biopsy, but sad to say the can`t figure out either malignant or benign. what shall I do now.
No, please don't do the Afirma test, I posted in The Thyroid Cancer Community recent articles by endocrinologists that were published in The American Thyroid Association's journal one by endocrinologist Dr.Jerome Hershman who reviewed an article by many university of Penn Dr.'s who endorsed this test and he who has the strongest criticism ,and then another by and there is another article I didn't post by Dr.Steven P.Hodak and David S.Rosenthal For The American Thyroid Association Clinical Affairs Committee.called, Information For Clinicians:Commercially Available Molecular Diagnosis Testing in The Evaluation Of Thyroid Nodule Fine-Needle Aspiration Specimens.
They all point out that in 48% of benign thyroid nodules,the Afirma test misclassified them as suspicious! And there was also a % of cancerous nodules they misclassified as benign! Dr.Hershman explains that out of the follicular neoplasm category,20 of 81 samples (25%) were malignant by pathology,and the GEC was suspicious in 18 of 20 but benign in two.Sixty-one of the 81 were benign,but 31 of them were classified as suspicious by GEC.
In the suspicious for malignancy category,34 of 55 samples,(62%) were malignant by pathology,and the GEC classified 32 of them as suspicious;of the 21 that were benign, the GEC classified only 11 as benign and the other 10 as suspicious. Of the false benign results,one was a Hurthle-cell carcinoma and the others were papillary thyroid cancers.It then says that of the seven false benign results for micrarray gene analysis.It says in the atypia category the GEC found that 57% (74 of 129) were suspicious.
In this series the proportion of the atypia category that were malignant,24%,is higher than expected; the GEC misclassified about 10% of the malignant nodules(3 o 31).It then says that it should be noted that about 30% of the benign nodules in the additional group were classified as suspicious by GEC. He says because of this the authors recommend that the test not be used for nodules that are cytologically benign,as the suspicious categorization may be tantamount to a recommendation for surgery.
They all point out that in 48% of benign thyroid nodules,the Afirma test misclassified them as suspicious! And there was also a % of cancerous nodules they misclassified as benign! Dr.Hershman explains that out of the follicular neoplasm category,20 of 81 samples (25%) were malignant by pathology,and the GEC was suspicious in 18 of 20 but benign in two.Sixty-one of the 81 were benign,but 31 of them were classified as suspicious by GEC.
In the suspicious for malignancy category,34 of 55 samples,(62%) were malignant by pathology,and the GEC classified 32 of them as suspicious;of the 21 that were benign, the GEC classified only 11 as benign and the other 10 as suspicious. Of the false benign results,one was a Hurthle-cell carcinoma and the others were papillary thyroid cancers.It then says that of the seven false benign results for micrarray gene analysis.It says in the atypia category the GEC found that 57% (74 of 129) were suspicious.
In this series the proportion of the atypia category that were malignant,24%,is higher than expected; the GEC misclassified about 10% of the malignant nodules(3 o 31).It then says that it should be noted that about 30% of the benign nodules in the additional group were classified as suspicious by GEC. He says because of this the authors recommend that the test not be used for nodules that are cytologically benign,as the suspicious categorization may be tantamount to a recommendation for surgery.
Have biopsy specimen evaluated using Afirma test: at least it will check it for cancer associted mutations.
What blood tests were done and what size is your nodule? If the nodule is small they are sometimes unable to get enough on the biopsy to give a diagnosis and will 'watch and wait' to monitor it as it grows. Many nodules are benign - Was a followup appointment made?
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