It almost always appears as an incidental finding, on a study ordered for another reason, and the report includes a classification that is rarely explained. We explain what it means, what it indicates and what the real options are.
Most are benign, but every one of them should be studied.
Between 5 and 15 % can be, and from the outside they cannot be told apart. That is why the first step is to study it, with an ultrasound and, if needed, a biopsy.
- 9 of 10thyroid nodules are benign.Figures quoted by Dr. Jacobo in the newspaper Hoy, May 2026.
- 5 to 15 %can be cancer, and only the biopsy says so.Same source. Yours is assessed with your report, at the consultation.
What your TIRADS means.
It is the classification the radiologist assigns to the nodule on the ultrasound, according to how closely it resembles a suspicious one. It is not a diagnosis; it is a probability, and it decides whether a biopsy is needed.
- TR1 and TR2Benign or without suspicious featuresNo biopsy needed. Surveillance is enough, especially if it causes no symptoms.
- TR3Mildly suspiciousBiopsy only if it measures 2.5 cm or more; ultrasound follow-up from 1.5 cm.
- TR4Moderately suspiciousBiopsy from 1.5 cm; follow-up from 1 cm.
- TR5Highly suspiciousBiopsy from 1 cm; follow-up from 0.5 cm.
Categories and thresholds of ACR TI-RADS (American College of Radiology, 2017). A TR5 does not mean cancer: it means it should be studied.
And what your Bethesda means.
It is the biopsy result, in six categories. Each carries its probability of malignancy and its next step.
- INon-diagnosticThe sample does not contain enough cells, and the puncture is repeated.
- IIBenignMalignancy around 2 to 4 %. The most frequent result. With two benign biopsies, the nodule can be followed or treated without surgery if it gives symptoms.
- IIIAtypia of undetermined significanceMalignancy 13 to 30 %. The biopsy is repeated or studied in more detail.
- IVFollicular neoplasmMalignancy 23 to 34 %. Usually requires surgery to know what it is.
- VSuspicious for malignancyMalignancy 67 to 83 %. Surgery is what is indicated.
- VIMalignantMalignancy 97 to 99 %. Surgery is what is indicated, and the surgical oncologist plans the rest of the treatment.
Bethesda System for Reporting Thyroid Cytopathology, 2023 edition. The ranges are those of the literature; yours is assessed with your report, at the consultation.
There are three options: watching, operating, or treating the nodule from the inside.
- Watch and waitMonitoring is also a medical decision.If the nodule is small, benign and causes no symptoms, surveillance by ultrasound is often what is indicated.
- SurgeryWhen there is cancer, surgery is usually what is indicated.It remains the right option for many patients, and it is performed by a surgical oncologist. In papillary cancer of one centimeter or less, the 2025 international guidelines also contemplate close monitoring or ablation: if your case meets the conditions, we explain it and decide together with you.
- Radiofrequency ablationThe nodule is shrunk from the inside and the thyroid stays in place.It is an option that is still little known: the gland keeps making your hormones, which is what sustains your quality of life. It does not suit every case, and that is assessed at the evaluation.
Which of the three applies to you is decided by what your ultrasound and biopsy show, and that is reviewed calmly at the consultation.
The first visit is for understanding, and decisions come afterwards.
Patients usually leave that visit knowing what they have, what their report means and what their real options are. Decisions come afterwards, calmly and with all the information.
- 01We review your studiesWe review your ultrasound, your biopsy if you already have it and your labs, and we explain what they say, including the classification in the report that usually goes unexplained.
- 02We complete what is missingIf the biopsy has not been done yet, it can be performed on the same day as the visit. Depending on the procedure indicated, we request the labs, the cardiology assessment and any tests your other conditions call for.
- 03With all the information, we decideAnd the decision may be to operate, to treat the nodule without surgery, or simply to watch it. We tell you with the same clarity.
Patient 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
What people ask after receiving their report.
Cystic ones (fluid) sometimes drain and shrink. Solid ones generally do not disappear; some stay the same for years and others grow. That is why they are monitored with ultrasound.
No. Goiter is the enlarged gland; a nodule is a localized growth inside it. There can be goiter with nodules and nodules without goiter.
Not necessarily. A benign nodule that grows or gives symptoms can be treated without removing the gland, if it meets the criteria. It is studied with two biopsies that agree.
It is a fine-needle puncture guided by ultrasound, with or without local anesthesia. It takes a few minutes and you return to your routine the same day.
It depends on the TIRADS and the size: from every six months to every two years. Your schedule is set at the visit with your report.
The next step depends on what your report says.
- If it is benign and causes symptomsFind out whether your case can be treated without surgery.Four questions to guide you before the consultation.
- If it is suspiciousWhen the nodule is cancer: diagnosis and treatment.We explain the types, the surgery and what changes afterwards.
- If surgery has been proposed to youA second look before deciding.If you send us your studies, Dr. Jacobo reviews them.
We invite you to present your report at the consultation; we will explain it calmly.
In person in Santiago, Santo Domingo or San Francisco de Macorís, or virtual from wherever you are. If you have no studies yet, the evaluation begins precisely with them.