Scenario:
- 5-1-2024 FNA Left lobe Thyroid: Follicular Lesion of Undetermined Significance (FLUS); see note:
NOTE: Afirma molecular testing was performed on the specimen and was found to be suspicious for malignancy (50% risk of malignancy).
- 5-17-2024 Physician Consult: Afirma test showed 50% risk of malignancy, refer for surgery
- 5-22-2024 Left Lobectomy: 2.1cm Papillary Carcinoma, follicular variant
Question: What is the date of diagnosis?
Answer: 05-22-2024
Discussion:
We are not to consider positive or suspicious Afirma tests alone as reportable. The Afirma test provides the risk of developing the disease, but it is not a diagnosis of the disease. The date this patient went on for surgery and received the reportable diagnosis of Papillary carcinoma, Follicular Variant, that is the date of diagnosis.
If the Physician had stated in retrospect or had stated the Afirma test diagnosed the cancer, then you could use the earlier date, but that was not the case in this scenario.