Ductal Carcinoma In Situ Discovery from Gynecomastia Surgery by Dr Ivan Puah
Gynecomastia can indicate underlying health concerns, including cancer. Surgery provides an opportunity to examine tissues for abnormalities.
August 6, 2025
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SINGAPORE, August 2025 — Dr Ivan Puah, an MOH-accredited liposuction doctor at Amaris B. Clinic, with decades of experience in male chest contouring and gynecomastia surgery, emphasises the critical significance of adhering to rigorous surgical protocols and conducting comprehensive diagnostics. This includes the essential practice of sending every case of gynecomastia surgery for thorough histological assessment.
Ductal Carcinoma In Situ Finding in a Male Patient in Early 30s
Dr Puah's patient with Grade III gynecomastia recently revealed the presence of Ductal Carcinoma In Situ (DCIS), a precancerous condition affecting milk duct cells, as noted in his pathology report.
The report indicated that, despite the absence of clinical signs of malignancy such as nipple retraction or bloody discharge, histopathological examination was indispensable.
This finding enforces the imperative nature of routine histological assessment of excised male breast tissue, even when the procedural presentation appears straightforward.
Potential Seriousness of Conditions Associated with Gynecomastia
Gynecomastia can often indicate underlying health issues. Numerous published case studies have documented instances of gynecomastia tissue containing DCIS as well as metastatic prostate cancer cells.
The surgical intervention not only reshapes the chest into a more masculine contour, but it also serves as a pivotal opportunity to examine excised breast tissue for possible abnormalities, including malignancies such as testicular or male breast cancer.
As male breast cancer can mimic gynecomastia or present as smooth, oval-shaped masses on imaging studies, early detection remains a challenge.
Given these unpredictable factors, Dr Puah highly recommends that any solid mass identified in enlarged male breast tissue mandates a biopsy for accurate diagnosis.
The Critical Importance of Early Detection
"Gynecomastia surgery transcends mere aesthetics; it facilitates the examination of tissues that may have been developing undetected for years. This medical condition demands serious attention."
Persistent breast changes should not be trivialised as simply 'fat' or 'bad genetics.' Men diagnosed with breast cancer frequently present at a more advanced stage, compared to their female counterparts, which can result in delays in receiving critical treatment.
Early detection saves lives.
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ABOUT AMARIS B. CLINIC & DR IVAN PUAH
Established in 2004, Amaris B. Clinic is a medical aesthetics, sculpting and fitness clinic in Singapore.
Led by Dr Ivan Puah, who is the clinic's Medical Director and accredited by the Ministry of Health to perform liposuction, Amaris B.'s forte lies in body sculpting - surgically removing stubborn fat pockets to sculpt and shape different areas of the body through various services offered.
Chairman of the Lipo Peer Review Committee in Singapore, Dr Puah obtained his Vaser liposuction (fundamental and hi-definition) training in Colorado and Argentina.
He has also received training in syringe liposculpture, fat grafting and thread lift by renowned French plastic surgeon, Dr Pierre Francois Fournier, and dedicated surgical training in gynecomastia surgery in San Francisco.
Dr Puah holds a Graduate Diploma in Family Dermatology from NUS, a Graduate Diploma in Acupuncture from TCMB, and a Graduate Diploma in Sports Medicine from LKCMedicine, NTU.
He is the appointed trainer by Allergan and Merz for fellow doctors on cosmetic injectables such as neurotoxins and dermal fillers, as well as the designated trainer for PDO thread lift and Picolaser from Venusys Medical in Singapore.
Amaris B. Clinic's signature treatments include:
