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If your thyroid biopsy came back inconclusive — Bethesda 3 or 4 — you may have been told surgery is your only option. But for decades, over 70% of those surgeries revealed nodules that were actually benign.
There's a better way. It's called molecular testing. And today's guest literally helped prove it works.
Dr. Joshua Klopper is the Medical Director for Endocrinology at Veracyte and a nationally recognized thyroid specialist with over two decades of experience managing thyroid nodules and thyroid cancer. He was an investigator on the original clinical study that validated the Afirma Genomic Sequencing Classifier — the test that has since helped millions of patients avoid unnecessary thyroid surgery. He served on the board of the American Thyroid Association and previously served as faculty at the University of Colorado School of Medicine.
⚠️ Conflict of Interest Disclosure: Dr. Klopper is an employee of Veracyte, maker of the Afirma Genomic Sequencing Classifier discussed in this episode.
In this episode, Dr. Klopper breaks down everything a patient needs to know about molecular testing — in plain language, without the jargon.
If you or someone you love has been told their thyroid biopsy is inconclusive — this episode could change the conversation with your doctor.
Chapters:
00:00 Introduction — The Indeterminate Thyroid Nodule Problem
01:55 Meet Dr. Joshua Klopper — Medical Director for Endocrinology at Veracyte
02:34 Understanding the Bethesda Classification System
05:38 The Human Cost of Unnecessary Thyroid Surgery
07:37 What Was the Patient Experience Before Molecular Testing?
10:18 What Is the Afirma Genomic Sequencing Classifier?
12:00 Why the Test Was Designed to Find Benign — Not Cancer
14:28 What Is a "Rule Out" Test and Why Does It Matter?
16:04 Oncocytic (Hurthle) Cells — Why They're Challenging
19:00 How Two-Thirds of Indeterminate Nodules Come Back Benign
21:27 Why It's Almost Always Safe to Pause Before Surgery
22:42 The Surgeon Bias Problem — Patients Deserve Options
25:37 How Patients Encounter Molecular Testing on Their Journey
29:43 What Happens to the Sample at Veracyte?
33:52 The 800-Patient Study — Long-Term Afirma Performance
41:24 What Does a Suspicious Afirma Result Actually Mean?
46:17 Risk of Malignancy — What the Numbers Really Mean
48:00 BRAF, RAS and Other Mutations Explained
53:30 The GRID Research Platform and Future Discovery
56:35 Molecular Testing and Ablation — What's Coming
58:33 One Message for Every Indeterminate Thyroid Patient
1:02:38 How to Learn More
1:05:56 Closing
📄 Study referenced in this episode:
Outcomes of Cytologically Indeterminate Thyroid Nodules Managed With Genomic Sequencing Classifier:
https://pubmed.ncbi.nlm.nih.gov/38415829/
🔗 Learn more about Afirma molecular testing:
https://www.veracyte.com/tests/afirma-thyroid/providers/
🔗 American Thyroid Association patient resources:
https://www.thyroid.org
🔗 Clinical Thyroidology for Patients (ATA):
https://www.thyroid.org/patient-thyroid-information/ct-for-patients/
📌 Resources:
👉 Podcast: https://www.saveyourthyroidwithjen.com/
👉 Patient site: https://www.saveyourthyroid.org/
👉 Private FB group: https://www.facebook.com/groups/saveyourthyroidnonsurgical
👉 Patient Navigation: https://www.saveyourthyroidwithjen.com/p/patient-navigation-services/
💛 Support the channel:
PAYPAL 👉 https://www.paypal.com/paypalme/itsmejenagain
VENMO 👉 https://account.venmo.com/u/itsme_jenagain
⚠️ Disclaimer:
This podcast is for informational purposes only and is not a substitute for professional medical advice. No endorsement is given or implied for any specific product, treatment, or physician mentioned. Always consult with a qualified healthcare professional regarding your individual medical needs.
🎵 Music:
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