Superficial thrombophlebitis of the breast

Superficial thrombophlebitis of the breast, often referred to as Mondor disease of the breast, is a benign and self-limited thrombophlebitis of the superficial veins of the breast and/or anterolateral chest wall. The exact etiology is unknown, but it may be associated with trauma (including breast surgery and radiation). The condition characteristically manifests with the sudden onset of a tender cord-like induration. Although the diagnosis is primarily clinical, age-appropriate breast imaging is required in all patients to rule out concomitant breast cancer. On imaging, superficial thrombophlebitis typically appears as a superficial dilated tubular structure with a characteristic beaded appearance; an intraluminal thrombus may be visible on Doppler ultrasound. Management is mainly supportive.

• Idiopathic
• Iatrogenic (e.g., breast surgery, breast biopsy, radiation therapy)
• Traumatic (e.g., tight brassiere use, strenuous exercise)

• Sudden onset
• Painful, thickened, cord-like lump or mass
• Overlying erythema of the superficial veins of the breast and/or anterior chest wall

• Primarily a clinical diagnosis
• Perform age-appropriate breast imaging in all patients to exclude underlying malignancy ^[1][3]
  • Breast ultrasound findings:
    • Superficial tubular structure with multiple areas of narrowing, giving a characteristic beaded appearance
    • On Doppler ultrasound, the tubular structure may be anechoic or an echogenic thrombus may be visible.
  • Mammography findings: often normal, but a superficial tubular structure with a beaded appearance may also be seen

Superficial thrombophlebitis of the breast may rarely be associated with underlying invasive breast cancer. ^[1]

• Primarily symptomatic: topical NSAIDs; see also “Management of mastalgia” ^[2]
• Reassurance