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Dr. Tan Chuan Chien

Microdochectomy

Microdochectomy is a surgical procedure designed to remove a single milk duct from the breast. It is performed when abnormalities or persistent issues associated with a specific duct are present, such as nipple discharge or a blockage. This procedure is used when less invasive methods are inconclusive.

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Pre-surgery Considerations

Before undergoing a microdochectomy, several important steps and considerations must be addressed to ensure the safety and effectiveness of the procedure. These include:

  • Medical Evaluation: A thorough medical evaluation assesses the patient’s overall health and suitability for surgery. This includes reviewing the patient’s medical history, medications, and allergies.
  • Diagnostic Imaging: Imaging tests such as mammography or ultrasound are usually performed before surgery. These tests help to pinpoint the affected duct and provide a clearer picture of the underlying issue.
  • Fasting: Patients may be required to fast for several hours before the surgery, typically starting from midnight on the day of the procedure.

Indications for Microdochectomy

Microdochectomy is recommended in specific cases involving the breast ducts. Key indications include:

  • Persistent Nipple Discharge: Particularly when the discharge is bloody or occurs spontaneously, suggesting an underlying pathology that needs further evaluation.
  • Pathology-Confirmed Abnormalities: When imaging or cytology indicates possible malignancies or premalignant changes in the duct.
  • Single Duct Pathology: Isolated issues confined to one duct, allowing for targeted intervention without affecting surrounding tissues.
  • Inconclusive Diagnostic Results: When non-invasive diagnostic methods such as mammography, ultrasound, or magnetic resonance imaging (MRI) do not provide clear results, a microdochectomy can be employed for diagnostic and therapeutic purposes.
DR. TAN CHUAN CHIEN

Key Guiding Philosophies

Competency

Dr. Tan is a Fellowship-trained Breast & Endocrine Surgeon who is registered on the Specialist Register (General Surgery) in both Singapore and Australia. He completed his formal Breast Surgery training through the BreastSurgANZ Fellowship Programme. He was previously Head, Division of Breast & Endocrine Surgery, NTFGH where he was the pioneer breast surgeon there developing a comprehensive, evidence-based Breast Surgery service.

Care for the wider community

Dr. Tan is passionate about engaging the wider community with regards to breast cancer outcomes. He volunteers with the Singapore Cancer Society and served as the Chairman of the Breast Cancer Awareness Campaign Committee from 2018 to 2021. He continues to currently serve as a member of this committee. During his time in the public hospital, Dr. Tan was involved in research on breast cancer screening and care, where he succeeded in obtaining competitive grants and managing a research team, with the overall aim to improve breast cancer outcomes in Singapore.

Patient-centered care

Dr. Tan believes in the importance of the patient experience and the partnership between doctor and patients in healing sickness. He also believes no two individuals are the same. He believes in the philosophy of personalised tailor-made care plans for each of his patients to meet their individual expectations and needs.

Comprehensive Breast, Thyroid and General Surgery service

Dr. Tan aims to provide comprehensive, evidence-based care to all his patients, in a modern equipped clinic along the entire spectrum of the patient journey from diagnosis, through treatment/surgery and aftercare.

The Procedure of Microdochectomy

The microdochectomy procedure is performed with precision to ensure effectiveness. Here’s an overview of the steps involved:

Anaesthesia

Typically performed under local anaesthesia, though general anaesthesia may be used depending on the patient’s preference and the surgeon’s recommendation. This ensures the patient remains comfortable and pain-free throughout the surgery.

Incision

A small incision is made at the edge of the areola, directly over the affected duct. This strategic placement minimises visible scarring and allows direct access to the targeted duct. The incision is usually about 1-2 centimetres in length.

Duct Excision

The problematic duct is isolated using fine instruments. The surgeon carefully excises only the affected duct to preserve as much surrounding breast tissue as possible. The excised duct may be marked with a surgical clip to help the pathologist identify the exact site of the abnormality.

Closure

The incision is carefully closed with sutures. In some cases, absorbable sutures are used, which dissolve naturally over time, reducing the need for suture removal. Non-absorbable sutures may be used and typically need to be removed within 7-10 days after the surgery.

The entire procedure typically lasts between 30 to 60 minutes. Patients usually return home the same day.

As a supporter of personalised surgical care, I understand that no two patients are the same. I believe in tailoring management for each patient to meet each individual’s needs and expectations. A patient’s journey can be difficult and frustrating at times, so I strive to make this experience as pleasant and seamless as possible.

Dr. Tan Chuan Chien
For Singaporeans, Singapore Permanent Residents and foreigners

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*NTUC Income (Extended Panel)

Frequently Asked Questions

How long do I wait before I can shower after the procedure?

Patients are usually advised to avoid getting the surgical site wet for the first 24 to 48 hours post-surgery. After this period, showering may be permitted, but soaking in a bath, swimming, or using hot tubs should be avoided until the incision is fully healed.

Will I need to wear a special bra after the procedure?

You will wear a supportive, non-underwire bra for a few weeks after the surgery. This helps to minimise movement and support the breast as it heals.

What should I do if I notice a lump or other changes in my breast after the procedure?

Any new lumps, changes, or irregularities in the breast tissue should be reported immediately. While these are often not serious, they should be evaluated to rule out complications or new issues.

Dr. Tan Chuan Chien

Consultant General Surgeon Breast & Thyroid Surgery
  • Bachelor of Medicine & Bachelor of Surgery (MBBS)- The University of Adelaide, Australia
  • Fellow of the Royal Australasian College of Surgeons (FRACS)
  • Full Registration, Singapore Medical Council (SMC) and Specialist Accreditation Board, Singapore (General Surgery)
  • Full General & Specialist Registration (General Surgery), Australian Health Practitioner Regulation Agency (AHPRA)
  • Completed Breast Surgery training through the BreastSurgANZ Fellowship programme
  • Fellow of the Academy of Medicine, Singapore (FAMS)

Dr. Tan Chuan Chien is a Fellowship-trained Breast and Endocrine Surgeon practicing as a Consultant General Surgeon at Gleneagles Hospital, Singapore. He also sees patients at Mount Elizabeth Novena Specialist Centre and Parkway East Medical Centre. Dr. Tan is a registered Specialist Surgeon (General Surgery) in both Singapore and Australia.

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Modern Facilities

We are equipped with modern and updated equipment, and a team that will take care of all your needs.

Accredited Specialist

Dr. Tan is a Fellow of the Royal Australasian College of Surgeons (FRACS). He is also accredited to practice as a Specialist in both Singapore and Australia.

Focused After Care

Dr. Tan firmly believes that transdisciplinary care is the key to every patient’s recovery journey.

Video-consultation for overseas patients

Dr Tan is available via video-consultations for patients who are not in Singapore.

Examination and Testing After The Procedure

The removed duct is sent to a laboratory for histopathological examination. This analysis is important for diagnosing the exact nature of the problem, such as identifying any benign or malignant cells. The pathology report usually takes a few days to be completed.

Aftercare and Recovery

The recovery process following a microdochectomy is important for ensuring a smooth healing period and preventing complications. Here are the key aspects of aftercare:

Pain Management

Patients may experience mild to moderate discomfort following the procedure. Pain can typically be managed with prescribed or over-the-counter pain relievers as recommended.

Wound Care

Instructions on wound care will be provided and typically include changing dressings regularly and watching for signs of infection.

Activity Restrictions

Patients are generally advised to avoid strenuous activities and heavy lifting for a certain period, usually a few weeks, to allow the surgical site to heal properly. Normal daily activities can be resumed gradually as comfort permits.

Follow-up Appointments

Regular follow-up appointments are necessary to monitor the healing process. These appointments are also an opportunity to address any concerns or complications that may arise.

Monitoring for Complications

It is important to watch for signs of infection, such as increased pain, redness, swelling, or discharge from the incision site. Any new breast symptoms or changes should be reported immediately.

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    MAIN CLINIC

    SOG - CC Tan Breast, Thyroid & General Surgery

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    SOG - CC Tan Breast, Thyroid & General Surgery
    (Mount Elizabeth Novena)

    SOG - CC Tan Breast, Thyroid & General Surgery
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    MAIN CLINIC

    SOG - CC Tan Breast, Thyroid & General Surgery

    OTHER PRACTICE LOCATIONS

    SOG - CC Tan Breast, Thyroid & General Surgery
    (Mount Elizabeth Novena)

    SOG - CC Tan Breast, Thyroid & General Surgery
    (Parkway East)