Dr. Witt said that it’s an exciting time in thyroid surgery. “Few fields in medicine rival the dynamism of modern thyroid diagnosis, management, and prognostication,” he said. “Molecular alteration testing, next generation sequencing, and gene expression classifier testing are the most important advances in the diagnosis and management of cancer since the introduction of fine needle aspiration cytology a half-century ago.”
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November 2014Keith Forwith, MD, PhD, an otolaryngologist at Advanced ENT and Allergy in Louisville, Ky., who sat in on the session, said some of the tests “aren’t ready for mainstream private practice outside of an academic setting, but they’re getting closer.” Afirma is now widely available, and he’s used it some, but he added, “Some of the patients that I’ve done it on have been hit with a $1,400 bill, so you have to be careful about whether that’s covered or not covered.” Also, whether to use such testing has to depend in part on the sophistication of the patient, he said. “This is not for an uneducated patient who has difficulty sorting through the science of it.”