Mondor’s Disease: Rare case of a painful breast lump in a middle-aged woman

Abstract

A 52-year-old postmenopausal female presented to the surgical outpatient department of the Armed Forces Hospital, Muscat, Oman, in 2015 with a mildly tender lump in the left breast of two weeks' duration. She had no associated fever or nipple discharge. The patient had six children whom she had breastfed normally. She was not lactating at the time of presentation and did not have a history of previous breast-related surgeries or trauma. A physical examination revealed a cord-like lump in the lower inner quadrant of the left breast that was mildly tender along with mild erythematic skin changes. The axillary lymph nodes were not palpable.Mammography and ultrasonography of both breasts was performed. The mammography images showed superficial diffuse cord-like tubular structures in both breasts, although these were more noticeable in the left breast [ Figure 1]. In addition, there was evidence of some skin thickening in the areola-nipple complex on the left side. Ultrasonography indicated that the structures were markedly dilated superficial veins.Some of these veins demonstrated flow on a colour Doppler ultrasound, while a few of the others demonstrated intraluminal thrombosis with no flow [ Figure 2].Based on the imaging findings, a diagnosis of bilateral Mondor's disease was made. The patient was treated symptomatically with anti-inflammatory and analgaesic medications. She responded well to treatment and became clinically asymptomatic six weeks later. At this time, a follow-up scan demonstrated resolution of the superficial venous thrombosis. CommentWith an incidence of approximately 0.5-0.8%, Mondor's disease is a very rare benign condition characterised by thrombophlebitis of the subcutaneous veins of the chest wall.1,2 The disease is named after Henri Mondor, a French surgeon, who first reported it in 1939.3 In most cases, the condition is idiopathic; however, it can be associated with a previous history of breast-related trauma, surgical procedures, biopsies