Superficial Thrombophlebitis of the Breast (Mondor’s Disease): An Uncommon Localization of Common Disease

Abstract

Mondor’s disease (MD), or superficial thrombophlebitis of the anterolateral thoracoabdominal wall, is a rare disease that presents with a palpable cord-like induration beneath the skin. It is a benign, self-limiting condition with probably underestimated significance due to the fact it may be a rare manifestation of an underlying breast carcinoma. It can also resemble breast malignancy and, if physician is not familiar with clinical features of MD, it may lead to unnecessary biopsy. The diagnosis is straightforward in most cases and it may be based on a thorough history and physical examination and it can be ultrasonographically confirmed. Raising awareness of this condition may facilitate recognition and diagnosing MD and eventually limit unnecessary diagnostic procedures.

Iron wire phlebitis – a disease of underestimated significance. COVID-19 as a factor increasing the risk of Mondor's disease

“…Mondor's Disease (MD), also known as iron wire phlebitis, is a rare and self-limiting superficial vein thrombophlebitis that presents with a palpable cord-like induration beneath the skin. [1]. Others symptoms include: pain, swelling and redness of the affected area.…”

“…MD is generally considered self-limited and benign, but there is a potential link with serious underlying diseases-malignancy (breast cancer, vascular neoplasm, cutaneous metastasis of any type of cancer), hypercoagulable state or systemic vasculitis, so these patients should be carefully examined and followed-up. [1] This condition was described in 1939, however, it is believed to have been depicted in 17th-century paintings by Rembrandt and Rubens. (Figure 1.…”

“…There is a possibility that it is more common than reported since the lesion is often nonpainful and self-resolving, so some patients do not seek medical attention. [1] The absence of clear diagnostic criteria and lack of needed awareness of physicians cause it to be underdiagnosed. Differential diagnoses of Mondor's disease include inflammatory breast cancer, mastitis, abscess, dilated duct (Table 1) and thrombophlebitis migrans, Buerger disease, Behcet disease and polyarteritis nodes [1,2].…”

“…[1] The absence of clear diagnostic criteria and lack of needed awareness of physicians cause it to be underdiagnosed. Differential diagnoses of Mondor's disease include inflammatory breast cancer, mastitis, abscess, dilated duct (Table 1) and thrombophlebitis migrans, Buerger disease, Behcet disease and polyarteritis nodes [1,2]. Mondor's disease of the breast is not commonly considered as a differential diagnosis for patients presenting with breast complaints.…”

“…In cases of breast MD, it is imperative for clinicians to correctly differentiate this condition from a breast cancer, which may be challenging-due to palpable finding and skin retraction, MD can resemble breast cancer on clinical exam. [1] It may lead to unnecessary biopsy, if physician is not familiar with clinical features of MD. [1] In some cases, the presence of Mondor's disease of the breast (MDB) led to the diagnosis of an underlying breast cancer.…”