Mondor's Disease

Mondor's disease is an uncommon condition of the pectoral region. Fage (2nd reference) first described this condition in 1870, but in 1939 it was characterized by Henry Mondor.

It is a benign condition. (photo credit)

It is manifest by thrombophlebitis of the superifical veins of the thoracic and abdominal walls (lateral thoracic, thoracoepigastric, and superior epigastric veins).

These superficial veins are painful, string-like subcutaneous cords on and around the breast. Occasionally there may be redness along the cord. The cord may be between 3-5 mm in diameter and 5-30 mm in length.

One or more or the above mentioned veins may be involved.

Involvement of the upper inner portions of the breast have never been described.

The etiology is not known.

Female to male ratio is 3:1. Most patients are in the 30-60 yr age range. The incidence rate after open surgical biopsy is less than 1%. Usually unilateral, but may be bilateral.

The condition subsides spontaneously after a few weeks. The time course is reported to be between 2 weeks and a few months. A fibrous cord may be evident for as long as a year.

Back to the etiology:

Most cases have no clear precipitating event and the exact pathogenesis remains unclear. The disease may be intiated by trauma, infection, or surgery. If there is no feasible reason for Mondor's disease (ie recent surgery, infection, use of breast veins for IV drug use), then a mammogram should be done to rule out any cancerous lesions. The coincidence of Mondor's disease and breast cancer has reported to be up to 12 percent in a series of 63 such patients.

Treatment is conservative.

• Local heat application
• Anti-inflammatories
• Reassurance
• In the absence of infection, antibiotic therapy is not warranted

REFERENCES

MONDORS DISEASE: An Unusual Complication of Mammoplasty; Plastic & Reconstructive Surgery. 56(3):319-322, September 1975; Fischl, Robert A MD; Kahn, Sidney MD; Simon, Bernard E MD

Mondor's Disease after Breast Reduction Surgery; Plastic & Reconstructive Surgery. 117(7):129e-132e, June 2006; Loos, Bernd M.D.; Horch, Raymund E. M.D.

Mondor Disease; eMedicine Article, Apr 30, 2008; Robert Schwartz, MD and Matthew Trovato, MD

Mondor's Disease of the Breast; AJR 2001; 177:893-896; Mahesh K Shetty and Alfred B Watson

Remarks on certain cutaneous affections; Guys Hosp Rep (3rd series) 1869;15:295 -302; Faage CH. (did not read, but found the reference in the above articles)

Tronculite sous-cutanee subaique de la paroi thoracique antero-laterale; Mem. Acad. Chir.1271, 1939; Mondor, H. (did not read, but found the reference in the articles above)

Phlebite en cordon de paroi thoracique; Mem Acad Chir, 70:96-98, 1944; Mondor, H (did not read, but found the reference in the articles above)