Breast: Mondor’s Disease

Published on 06/06/2015 by admin

Filed under Obstetrics & Gynecology

Last modified 22/04/2025

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Chapter 153 Breast: Mondor’s Disease

INTRODUCTION

Description: Mondor’s disease, or superficial angiitis, is a superficial thrombophlebitis of the breast.

Prevalence: Uncommon.

Predominant Age: 30 to 60.

Genetics: No genetic pattern.

ETIOLOGY AND PATHOGENESIS

Causes: Phlebitis is most often linked to recent pregnancy, trauma, or operative procedures but may occur spontaneously. It most often involves the thoracoepigastric veins of the breast.

Risk Factors: Pregnancy, trauma or operative procedures, thrombophilias.

CLINICAL CHARACTERISTICS

Signs and Symptoms

• Pain (acute, generally upper outer quadrant)

• Dimpling of the skin or a distinct cord with erythematous margins

• Shallow groove seen extending upward toward the axilla when the arm is raised

DIAGNOSTIC APPROACH

Workup and Evaluation

Laboratory: No evaluation indicated.

Imaging: Mammography may be required to rule out other processes, but the diagnosis is generally established by examination and history.

Special Tests: On rare occasions, biopsy may be required to establish the diagnosis.

Diagnostic Procedures: History and physical examination. (Accentuation of dimpling, or the formation of a groove over the affected vein, often occurs when the ipsilateral arm is raised during physical examination.)

Pathologic Findings

Thrombophlebitis of the superficial veins.

MANAGEMENT AND THERAPY

Nonpharmacologic

General Measures: Evaluation and reassurance, symptomatic therapy.

Specific Measures: Analgesics and heat reduce symptoms. The condition generally resolves in 2 to 3 weeks, but it may take 6 weeks or longer.

Diet: No specific dietary changes indicated.

Activity: No restriction. Good mechanical support improves comfort during vigorous activity.

Patient Education: Instruction on monthly breast self-examination; American College of Obstetricians and Gynecologists Patient Education Pamphlet AP145 (Breast Self-Examination), AP026 (Detecting and Treating Breast Problems), AP029 (Breastfeeding Your Baby), AP076 (Mammography).

Drug(s) of Choice

Nonsteroidal anti-inflammatory agents (NSAIDs). (Antibiotics and anticoagulants have little effect on the course of the disease and are not indicated.)

FOLLOW-UP

Patient Monitoring: Normal health maintenance.

Prevention/Avoidance: Avoidance of breast trauma.

Possible Complications: Unlikely.

Expected Outcome: Mondor’s disease is self-limited, although full resolution may take 8 to 10 weeks.

MISCELLANEOUS

Pregnancy Considerations: No effect on pregnancy.

ICD-9-CM Codes: 451.89.

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