Background
First described in detail by Henri Mondor in 1939, this condition is a rare entity characterized by a sclerosing thrombophlebitis of the subcutaneous veins of the anterior chest wall, as diagrammed in the image below.
Illustration of the venous channels involved in Mondor disease. A is superior epigastric vein. B is thoracoepigastric vein. C is lateral thoracic vein. The sudden appearance of a subcutaneous cord, which is initially red and tender and subsequently becomes a painless, tough, fibrous band that is accompanied by tension and skin retraction, is characteristic. The condition, though benign and self-limited, has been associated with breast cancer. It requires only symptomatic therapy. However, the physician must be aware of its existence to properly diagnose it and to rule out the presence of systemic disorders, especially breast cancer.[1]
Subcutaneous penile vein thrombosis (penile Mondor disease) has also been described.[2] Its pathogenesis is unknown. It appears suddenly as almost painless indurations on the penile dorsal surface.
A related eMedicine article is Superficial Thrombophlebitis.
Pathophysiology
The pathophysiology has been explained as pressure on the vein with stagnation of blood or as direct trauma to the vein itself. In cases that do not show such evidence, the most reasonable explanation is on the basis of repeated movement of the breast along with the contracting and relaxing pectoral muscles, which causes stretching and relaxing of the veins.[3]
Mondor disease may only involve 1 or more of 3 venous channels: the thoracoepigastric vein, the lateral thoracic vein, and the superior epigastric vein. The upper, inner portions of the breast are never involved. Mondor disease can also occur on the penis, groin, antecubital fossa, and posterior cervical region.[4]
Although most often linked with breast cancer surgery and anesthetic mammaplasties, it may also occur as a result of excision of axillary nodes after gel silicone breast implant rupture.[5]
Epidemiology
Frequency
International
Fewer than 400 cases have been described worldwide.[6] . However, its incidence after breast cancer surgery and aesthetic mammaplasties has been estimated at 1%.[5]
Race
No racial or ethnic predilection is evident.
Sex
Mondor disease is 3 times more common in women than in men.[7]
Age
The disease can occur in persons of any age, but most patients are aged 30-60 years.[7]
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