Be Aware of Afirma GEC Suspicious Result in Indeterminate Thyroid Nodules. Many More Are Not Cancer, But the look alike Benign Noninvasive Follicular Neoplasm with Papillary-like Nuclei called NIFN-P.
Cancer Cytopathology 2017 published online
Hang JF et al
- 384 suspicious nodules had GEC suspicious results.
- 177 had a thyroidectomy.
- Re-classified NIFT-P cases caused the positive predictive value to decrease from 42% to 24% in AUS and 24% to 13 % in SFN group.
- Too many total thyroidectomies were done with GEC suspicious result compared to lobectomy.
- REclasification of NIFT-P has made GEC suspicious less valuable as it’s ability to diagnose cancer is significantly decreased.
- While many still need surgery, most would only need a lobe rather than a total.
- With improved diagnosis of NIFT-P on the needle biopsy specimens the need for diagnostic lobectomy would be unnecessary.
- The risk of complications from a total thyroidectomy for a benign condition would not occur.