This is a small follicular neoplasm. The risk of malignancy maybe 15-20%. You have done your homework very well in terms of the initial and followup research on the Afirma testing. For a small nodule like this, close observation may be reasonable unless there are suspicious features or lymph nodes on ultrasound. A repeat biopsy may also be helpful, sometimes sending the slides to another pathologist can help clarify the situation as well. If there is still question and the plan is to try to avoid surgery, then Afirma testing can be quite helpful in many cases.
Thank you very much, it is great what you told me. Now I have a doubt about the test, maybe I will traver to usa for holidays and I can have the test afirma anyway. But I have a doubt and no endo here has the knowledge to know the answer. From what I understand because my endo explained to me is If you have a nodule and make a regular FNA and comes back as indeterminate, follicular neoplasm etc... and then you make a second FNA and it comes back as benign this second result doesn´t invalidate the result of the first FNA. And the explanation of it is that maybe the second aspiration was of healthy tissue of the nodule and the first not healthy tissue of the nodule.
So, how this applies to the affirma test? It can happen that when you perform the FNA for the affirma you aspire healthy tissue and of course it will come back as benign as any regular FNA.
Is there a way to make shure you aspirate "indeterminate" tissue to repeat the citology with simmilar tissue you had in the first FNA?