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What is genetic testing for thyroid nodules?
Do I need to have this performed on my biopsy? Who performs this test?

Science Lab

Genetic testing is one of the newest tests that can be performed on thyroid nodules. It is important since it can help determine whether a nodule in the thyroid is at risk for being a cancer. Many FNA (fine needle aspirate) biopsies come back with follicular cells that are the normal cells that make up the normal thyroid gland. Sometimes it is impossible for any pathologist to tell the difference between benign or cancerous follicular cells. This is how the genetic test on the FNA cells becomes key.  If the FNA biopsy with the gene test comes back benign (and other things such as the ultrasound, exam, and family history are not suspicious for a cancer), then normally a patient would NOT need to have thyroid surgery or removal of a portion of the thyroid gland. This is what happens the majority of the time when such testing is done.

In the past, patients who had follicular cells on an FNA biopsy were advised to have their thyroid removed, since the pathologist would not be able to definitively rule out cancer. Now some of these same patients can be safely followed without surgery, and instead doing close follow up with physical exams and neck ultrasounds by their thyroid surgeon or endocrinologist. However, not all surgeons perform this type of biopsy so it is very important to ask your surgeon if they do the genetic testing for thyroid nodules (such as the AFIRMA biopsy).  

In our practice, the number of patients requiring surgery for benign nodules has decreased since we began the use of biopsies with genetic testing. It is the most accurate method we presently have to assure these patients that they do not need surgery. As more patients and the general public learn more about the thyroid and the multiple options available for care, many are requesting this genetic test to be performed at the time of their FNA biopsy.

Does Dr. Brady offer the genetic test for the thyroid FNA biopsy?

Dr. Brady can perform this type of FNA biopsy by Afirma even on the first office visit along with a neck ultrasound. In fact, both of these doctors are on the Speaker’s Bureau for Afirma and presently speak to local doctors and other medical professionals to inform them about this genetic biopsy as an option for their patients.

How long after the thyroid FNA biopsy is performed are genetic results completed or available?

The pathologist begins with the testing by examining the thyroid cells from the FNA biopsy. If they recommend further genetic tests to be completed on the cells, they are then sent out for the special genetic testing.  It might take up to 10-14 days after the biopsy was performed to get the completed results because of the advanced nature of the testing.

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