A Benign Gene Expression Classifier Result on an Indeterminate Thyroid FNA May Reduce the Need for Thyroidectomy

who obtained the AGEC on cytologic specimens of thyroid nodules >1 cm whose FNAs were read as indeterminate. When the AGEC was classified as negative for malignancy, the investigators determined whether patients were referred for surgery. In addition, the basis for surgery was determined. Results The study analyzed data on 368 patients (395 nodules) with a median size of 2.4 cm. Surgery was performed on only 28 patients (7.6%) of those whose FNA was cytologically indeterminate but whose AGEC was benign; the predicted number based on other data compiled by Veracyte investigators would have been 74% (2). The primary reasons that surgery was recommended to the 28 patients with benign results on AGEC were that the nodule was large in 13 patients, symptomatic in 7, rapidly growing in 3, symptomatic in 7, a second suspicious nodule in 3, suspicious on ultrasonography in 2, suspicious on cytology in 2, and not otherwise specified in 12. (Apparently, patients could have more than one reason.) Hemithyroidectomy was the surgery for 68% of the patients; the rest had a total thyroidectomy. Conclusions