How Good is a Suspicious Afirma test result in detecting thyroid cancer? Not too good compared to thyroid cytology

How Good is a Suspicious Afirma test result in detecting thyroid cancer? Not too good compared to thyroid cytology

How Good is a Suspicious Afirma test result in detecting thyroid cancer? Not too good compared to thyroid cytology

How Good is a Suspicious Afirma test result in detecting thyroid cancer? Not too good compared to thyroid cytology.

Roychoudhury et al Diag Cytopathol: Feb. 2017

Afirma is effective in determining a benign nature of a nodule. However, a suspicious result does not do the same for diagnosis of cancer. 69 cases studied had suspicious Afirma result. 11/60  had cancer or 82% were benign at surgery and only 18% were cancers.The rate of cancer with a cytology result of suspicious for neoplasm was double 5/16 or 32% the Afirma rate. Afirma suspicious had a false positive rate of 56% 32/57. Suspicious for neoplasm cytology was better than a suspicious Afirma test in predicting cancer.

Comment: Afirma alone is not a good test when the result is suspicious but is good at detecting benign nodules when the result is benign. A novel test from Interpace combines molecular marker testing ThyGen X with a reflex classifier similar the Afirma.

Richard Guttler MD,FACE,ECNU

thyroid.com

2 Comments
  • Tammi Rawding May 15, 2018 9:19 pm

    Hi Dr. Guttler – my thyroid FNA showed indeterminate/suspicious (Bethesda 3), and my Afirma unfortunately resulted in the same. Are there other more precise genetic tests out there now that determine a more specific positive for a malignancy (since the Afirma could not say benign)? Should I ask my doctor to run the Interpace ThyGenX as well? The surgeon I consulted with said that unfortunately the indeterminate/suspicious cells will always be there, and those are not likely to ever show benign… And so, if all tests point “prognosis negative”, is a thyroidectomy (hemi) my only option for treatment, or are laser or radiofrequency ablation procedures options at this time? If Y, who in the US is performing them? Your insight is greatly appreciated! Thank you! T.

    • Dr Guttler May 16, 2018 8:57 am

      Tammi,
      Afirma is a bad test when it show suspicious.
      It is only good to confirm benign.
      The surgeon wants to rush you to surgery.
      Get another opinion.
      Come to see me for a overnight visit to get a proper evaluation.
      All options are on table including no surgery, or ablation.
      DR.G.
      310-393-8860
      thyroid.manager@protonmail.com

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