At the Viewbox: Mondor’s Disease

Mondor’s Disease

Can you tell why this patient presented?

The arrow on the mammogram points to an acutely painful, palpable, superficial tubular mass coursing toward the nipple. The ultrasound image demonstrates a superficial, anechoic, tubular structure with multiple areas of narrowing and intraluminal echogenicity (arrowhead). Color Doppler analysis shows absence of flow within the tubular structure. These findings are consistent with superficial thrombophlebitis, also known as Mondor’s disease.

Mondor’s disease is a rare, self‐limiting, generally benign condition of thrombophlebitis of the superficial veins of the breast and anterior chest wall. This entity is often idiopathic; however, known causes include trauma, breast augmentation, breast biopsy, breast cancer, inflammation, and infection. The classic presentation of a painful, palpable, cord‐like structure often aids in avoiding misdiagnosis of the enlarged vein as a dilated duct. Also, thrombosed veins are longer, have a beaded appearance, and do not terminate at the areola. Since there have been occasional cases of associated breast cancer, imaging is warranted to exclude underlying malignancy. Management includes warm compresses and pain relievers (NSAIDS) with a 6‐month follow‐up examination. If findings are unresolved on follow‐up, surgical excision may be considered.