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November 24, 2025
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Gynecomastia, characterised by enlarged male breast tissue, affects up to 65% of men globally. While often benign, it can sometimes signal underlying health concerns. It is linked to hormonal fluctuations during puberty, ageing and the use of certain medications, chronic illnesses, or underlying tumours.
Dr Ivan Puah, an MOH-accredited liposuction doctor with vast experience in male chest contouring and gynecomastia surgery, emphasises that “gynecomastia isn’t just a cosmetic issue. Addressing it not only reshapes the chest for a more masculine contour but also provides an opportunity to evaluate excised breast tissue for potential abnormalities.”
Gynecomastia and Its Link to various Health Risks
Gynecomastia has been linked to systemic diseases such as liver cirrhosis, hyperthyroidism, kidney failure, as well as cancers of the testicles or breasts.
Testicular Cancer
While most cases of male breast enlargement (gynecomastia) may stem from harmless hormonal shifts, it’s important to know that it may also signal underlying health concerns such as testicular cancer.
Studies indicate that roughly 10% of testicular cancer cases first present as unexplained breast growth, while about 2% of men with gynecomastia are later found to have testicular tumours [1, 2].
Male Breast Cancer
Male breast cancer is rare. However, a 2024 study suggests that its occurrence is gradually increasing. What makes it more concerning is that male breast cancer can share similarities with gynecomastia, especially in how it develops beneath the nipple area.
This overlap can sometimes make early detection challenging, highlighting the importance of proper medical evaluation and diagnosis [3].
Male Breast Cancer Case Studies
Male Breast Cancer Case Study #1 (32-Year-Old Male)
A study titled “Anatomy of the Gynecomastia Tissue and Its Clinical Significance” by Blau et al. revealed that gynecomastia tissue in a young patient contained Ductal Carcinoma In Situ (DCIS), a precancerous condition affecting milk duct cells. This discovery led to life-saving bilateral mastectomies [4].
Male Breast Cancer Case Study #2 (60-Year-Old Male)
Another patient with a history of prostate cancer underwent gynecomastia surgery, only for histology to detect metastatic prostate cancer cells within the excised tissue. The delayed diagnosis resulted in a poor prognosis, requiring aggressive treatment with estrogen analogs [4].
Men diagnosed with breast cancer are often at later stages compared to women, which can delay critical treatment. Imaging scans of male breast cancer typically resemble features seen in female breast cancer—such as irregularly shaped masses with jagged edges and sometimes tiny calcium deposits. However, these masses can, in some cases, appear deceptively benign on scans, presenting as smooth, oval-shaped lumps [4].
Because of this unpredictability, Dr Puah stresses that any solid lump detected in a man’s breast tissue should be biopsied for an accurate diagnosis.
A Case Of Incidental Finding Of DCIS Found In A Young Gyno Patient Treated By Dr Ivan Puah
“I saw a man in his early 30s with Grade III gynecomastia, who had been living with this condition for a couple of years. His primary concern was to remove the enlarged breast tissue and regain his confidence, as the condition took a toll on him emotionally and physically.
Physical examination revealed the classic symptoms of gynecomastia: bilateral swollen breasts with tenderness, the presence of fat tissue, and skin redundancy. I also ordered thorough blood investigations to assess various profiles.
Gynecomastia surgery was performed using a combination of the MDC-Sculpt® Lipo technique to remove excess fat tissue and the 360°GTD® technique to excise the dense glandular tissue.
When the excised tissue was sent for routine histological assessment, the pathology report revealed Ductal Carcinoma In Situ, a non-invasive precancerous condition, within the breast tissue. This was an incidental finding, as the patient did not exhibit signs of malignancy, such as nipple retraction or bloody discharge during our clinical examination.
My team and I immediately coordinated with the respective specialists to ensure he received further investigations and prompt follow-up care.
This case stands out to me for two reasons. First, it reinforces a key message I share with every patient: Gynecomastia surgery isn’t just about aesthetics; it provides an opportunity to scrutinize tissue that has been growing, sometimes for years, without supervision.
Second, it highlights the importance of meticulous surgical protocols and thorough diagnostics, even in seemingly straightforward procedures,” shares Dr Ivan Puah, medical director of Amaris B. Clinic, with over 20 years of liposuction and body sculpting surgical experience in Singapore.
Why Early Action Matters
Men struggling with gynecomastia should take this medical condition seriously. Don’t dismiss persistent breast changes as "just fat" or "bad genetics." If you notice breast enlargement, tenderness, or lumps, it is important to seek evaluation promptly.
Take Charge of Your Health
Gynecomastia surgery is not just about addressing an aesthetic concern; it’s also a significant step towards long-term well-being. Schedule a private consultation with Dr Ivan Puah to discuss your concerns.
