Requesting info regarding Afirma thyroid FNA analysis.

Hi


After noticing a lump in my thyroid, I have had my biopsy and ultrasound and both has come back as inconclusive and the blood results were normal. In view of this, my specialist (after discussion with a Multi Disciplinary Team) has suggested removal of right portion of my thyroid.

I have been researching regd inconclusive results and came across the Afirma test provided by an American company called Veracyte. This test involves testing DNA of the cells taken during biopsy to determine malignancy. [Think I got this explanation right....as much as I understood]


Does anybody have any knowledge of this test? Is it available in the UK? If so is it available via NHS?  Will be grateful for any insight into this new test.

  • Hello, I'm not familiar with this special type of FNA test - although I did a bit of googling. Much of what you see that's negative about FNA testing is about that technique in general - and not necessarily about the special version. If you are in the UK where a standard FNA is not going to cost you a bean, I'd go for that first. It can come back conclusively positive, conclusively negative but rather often it's inconclusive. As I understand it, follicular TC can not be diagnosed without removing the whole thyroid, so whatever test you go for probably won't make a difference.

    I would advise to do the standard one and only look to pay extra for a retest if the initial results are inconclusive.

    If you are not in the UK, then all bets are off. Just check how much more it's going to cost for the Affirma than a standard FNA before you get your credit card out.

    Regardless of what direction you take, you do need to get an FNA done, sooner rather than later. Nothing can move forward with your diagnosis without taking that step.  (I am assuming you've already had an ultrasound test - is that correct?)

    Best wishes

    Barbara

    “Scars are tattoos with better stories.” – Anonymous

  • Hi thankyou so much for your reply.

    I have had ultrasound and inconclusive FNA on NHS yes, I hadnt realised most follicular cancer FNAs are inconclusive..the Afirma is an option I am considering now and doing some research, it is genetic, so a different test entirely.

    Thanks again and I hope you are now well.

  • I had a little chat with Dr Google and found this really interesting article from a US thyroid centre. https://www.thyroidcancer.com/thyroid-cancer/follicular/diagnosis

    This states that whilst the Afirma test could be used to prove something IS NOT a follicular cancer, it can't be used to prove anything IS.  It mentions two other test types that may be able to do this.

    So, I'm inclined to think you might well be wasting your money.

    The paper says something like 10% of Thyroid Cancers are follicular but I suspect that's misleading as it probably includes all the anaplastic and medullary cancers which are highly unlikely to be your type. 

    How big is your lump? And (apologies for being cheeky) what's the cost of the afirma test?

    Best wishes

    Barbara

    “Scars are tattoos with better stories.” – Anonymous

  • Hi thanks for taking the time..I didnt actually see the other 2 tests, but will look further. Ive been trying to contact a Harley St clinic for more info on the test and cost but not managed to get through as yet today!

    My results say "a max 40mm diameter with suspicious appearance TR3. FNA showed hyperplastic nodule with poss risk of follicular neoplasm THY3F"

    I know nothing of what this really means except he suggests a risk of malignancy of 1 in 5 to 1 in 10 & a diagnostic thyroid lobectomy. Not keen unless absolutely necessary as Im sure you can appreciate.

    Best wishes