SantiagoHEMA
Specialized Hospital for Advanced Medicine: labs, cardiology and the procedure in the same building, fifteen minutes from the airport. The most practical choice if you fly in.
Thyroid biopsy
It is performed with a fine needle guided by ultrasound, at the office, in about fifteen minutes and with no admission. It is the test that confirms whether a thyroid nodule is benign. Dr. Jacobo performs it in Santiago and Santo Domingo.
The procedure
The procedure, step by step.
- 1It is located with ultrasoundYou lie down, with the neck slightly extended. The ultrasound shows the nodule in real time and guides the needle.
- 2Local anesthesiaIt is applied to the skin. Many patients do not need it, because the needle is thinner than the one used for a blood draw.
- 3Two or three passesEach takes seconds. Enough material is taken for the pathologist. You may feel pressure, not pain.
- 4You return home the same dayA small dressing is applied and you can resume your activities, including work, that same day. The result takes one to two weeks.
The result
What the result means.
The pathologist classifies it into six categories, the Bethesda system. The two most relevant: Bethesda II is benign, and the most frequent; Bethesda VI is malignant. The intermediate ones (III and IV) are indeterminate and sometimes call for repeating the biopsy or performing another test. With the result, the decision is made: monitor, treat with ablation or operate.
Bethesda System for Reporting Thyroid Cytopathology, 3rd edition, 2023.
Why two
Why two biopsies are required before ablating.
A benign biopsy is not an absolute certainty. In a Korean series of 148 nodules ablated with a prior benign biopsy, seven turned out to be cancer, and six of those seven had two benign biopsies. That is why guidelines require two concordant punctures before an ablation, and recommend a core needle instead of a fine one in large nodules. It is a step that is completed before any ablation.
- 4.7 %of 148 “benign” nodules turned out to be cancer in that series.Kim MK et al., Korean J Radiol 2023; Korean Society of Thyroid Radiology, 2017 guideline.
- 2concordant biopsies before treating a nodule as benign.Korean Society of Thyroid Radiology, recommendation 1-2.
With the result
The result opens one of these three paths.
- Benign and with symptomsFind out whether your case can be treated without surgery.Four questions to guide you before the consultation.
- Bethesda V or VIWhen the nodule is cancer: diagnosis and treatment.We explain the types, the surgery and what changes afterwards.
- Bethesda III or IVA second look before deciding.Indeterminate is neither benign nor malignant with certainty: there is more than one path.
Google reviews
5.046 reviewsSee on GooglePatient reviews.
Thyroid and cancer surgery patients, and patients from abroad, tell how their experience with the doctor was.
I want to express my deepest gratitude to the doctor for being my guide and support during one of the most difficult times of my life: my thyroid cancer treatment. From…
Yaskira PerezMay 2026Dr. Jacobo is highly professional, skilled, and incredibly kind. He takes the time to explain every step and every procedure, ensuring his patients have no unanswered…
Rosemil OvalleFebruary 2025Dr. Jacobo is an excellent professional with world-class attention to detail. When treating a close relative with thyroid surgery, at a leading center in the field, he…
Anthony TejadaJanuary 2025Wonderful doctor. I had no idea I'd been suffering from thyroid problems for some time, and you gave me an accurate diagnosis that changed my life. Thank you so much…
Ana AguileraJanuary 2025I had a total thyroidectomy performed by Dr. Jacobo. It was a difficult surgery, but I came out of the operating room feeling excellent. Dr. Jacobo loves what he does…
Sheila Sabrina Calderon cuelloJune 2025I am incredibly grateful for the care I received from Dr. Jacobo. I initially found him through a Google search while looking for alternative treatment options for my…
Kate LockhartMarch 2026My husband was diagnosed with colon cancer. Amidst our worry, we chose Dr. Jacobo because I was struck by his genuine and selfless interest in my husband's diagnosis. He…
Nidia AcostaSeptember 2025Dr. Joan is a physician with outstanding professional training and a true calling: compassionate, approachable, and always attentive, not only to his patients but also to…
Andi AlmanzarSeptember 2025I recently underwent surgery by Dr. Joan Jacobo, and there's nothing better than the safety and peace of mind for a patient and family, ensuring their health is in the…
Omar Encarnación UlloaSeptember 2025An excellent doctor, my dear Dr. Jacobo. After seeing many doctors without a clear answer about what was wrong with me, I finally found Dr. Jacobo. With great care and…
Alexandra Fontana ReynosoJanuary 2025I want to express my sincere gratitude to the doctor for his excellent work and dedication. From the very first moment, he instilled confidence, security, and a human…
Josmeiry PaulinoMarch 2026Dr. Joan Jacobo studied and performed a brain scan for my mother, and the experience was much more bearable thanks to his wonderful professional and, above all, humane…
Anibelka MenaApril 2024I want to highlight Dr. Joan's excellent service, experience, and dedication to his patients. Personally, I want to emphasize that few doctors dedicate the time, care…
Massiel LizardoJuly 2025Dr. Jacobo is a specialist who inspires great confidence and security. He knows how to soothe the anxiety that comes with having to see him! He's a doctor at the…
Jenny Guzman De GonzalezApril 2024Dr. Joan Javier Jacobo is an excellent oncology professional. He is highly qualified and recommended by other oncologists in the country. I wholeheartedly recommend him.…
Angelica MejiaAugust 2024Dr. Joan Javier Jacobo is an excellent professional and physician with a genuine and compassionate nature that is highly effective for his patients. I, his patient for…
Mariela Jiminian CamiloApril 2024An excellent doctor, dedicated to his patients, providing exceptional care with love and dedication. You are a doctor who inspires confidence; all patients should have an…
Jisselle PaulinoFebruary 2025An excellent professional, ethical, committed, and approachable. A doctor who, in addition to being highly qualified, provides his patients with peace of mind…
Mercedes RosarioJune 2025My dear Dr. Jacobo, for me you are an excellent doctor, kind, gentle, and a great professional. I had kidney surgery performed by him and I feel very well. I bless you…
Margaret CastrillonJanuary 2025Dr. Joan took the time to listen attentively, answer all my questions, and explain everything clearly and calmly. I felt heard, well cared for, and in good hands…
Lizvanessa JavierApril 2026
About the biopsy
What people ask about the biopsy.
Most patients compare it to a blood draw, and there may be some neck discomfort that day.
It depends on the center and on whether it is performed at the same visit. The cost is given to you in writing when you book, before you come.
There is no need to fast. If you take blood thinners, it helps to mention it when booking: sometimes they are paused one or two days before.
Yes, if the report is complete and classified by Bethesda. If you present it, a new puncture may be avoided.
Bethesda III or IV. Neither cancer nor benign with certainty: sometimes it is repeated, sometimes an additional test is performed, and in some cases surgery is needed to know. It is explained at the visit, calmly.
Locations
Choose the center closest to you.
Santo DomingoClínica Abreu
In Gazcue, in the center of the capital, about 35 minutes from the airport. The clinic's first radiofrequency ablation session took place here.
San Francisco de MacorísCentro Médico Siglo 21
Office in suite 106, for patients in the northeast who prefer not to travel to Santiago.
If you have a recent ultrasound, the biopsy can be performed the same day.
In Santiago and Santo Domingo. It is arranged when you book, and the cost is given in writing before you come.