Mondor’s disease is a rare disorder characterized by inflammation and hardening of superficial vein under the skin of anterior chest wall and breast. The disease is named after Henry Mondor who first described the condition in detail as a separate disease entity in 1939. The disease is caused due to clotting of blood in the superficial subcutaneous veins of chest wall and breast and sometime of penis and axilla.
Infection, trauma and surgery in this region are common causes. Adult women are more affected with Mondor’s disease than men. The most common presentation of this disease is sudden appearance of red, swollen painful lump underneath the skin of anterior chest wall or breast skin.
The disease is easily diagnosed with clinical examination and Doppler study. Treatment is conservative. The swollen cord heals with anti inflammatory medicines within few days or a week.
Causes And Risk Factors For Mondor’s Disease
Mondor’s disease is caused due to clotting of blood in the subcutaneous veins of chest wall and breast. It is an uncommon condition with very rare incidence occurring usually in females between 30 to 60 years of age. Males too can suffer from this condition sporadically. Mondor’s disease can also occur in penis, underarm, groin, neck besides breast and frontal chest area.
Clotting of blood in the subcutaneous vein in mentioned anatomical area can occur due to two reasons. It can be due to direct pressure and compression on the vein that causes stagnation and clotting or it can be due to infection and trauma.
Several risk factors have been associated with the disease such as:
- Injury to breast.
- Surgical trauma especially after breast tissue biopsy.
- Infection in the breast.
- Repeated movement of large pendulous breast which can cause frequent contraction and relaxation of the veins.
- Trauma caused by wearing tight brassiere.
- Hereditary clotting disease.
- Shaving of underarm and bikini area or hairs on chest.
- Intravenous abuse of drugs.
- Tight dressing
Symptoms Of Mondor’s Disease
The symptoms of Mondor’s disease develop abruptly in front part of chest and breast or sometimes in other areas that include groin, penis, underarm, and neck. Below are given important clinical and subjective symptoms of this disease:
- Sudden onset of pain mainly in the localized area of its occurrence. It is superficial pain that can last for one week or a month.
- The area affected due to trauma or infection is swollen and becomes tender.
- Soon a palpable cord develops that is felt like a lump in the area. The skin above it is red and inflamed. The cord is visible and appears as ribbon like or a bowstring. When present on breast, the cord or hard lump forms a furrow when the arm is raised or breast is examined. The length of hardened cord (Lump) is usually 5 to 10 cm and it is 3 to 5 mm broad.
- Pain gets aggravated in the cord or lump with movement.
- Sometimes there is risk of clot separating and lodging in deep vein causing deep vein thrombosis. It may also get dislodged into the lung leading to complication of lung emboli.
Treatment For Mondor’s Disease
Mondor’s disease is self limiting and benign condition. The hardened lump usually becomes painless mass after sometime and heals over a period of time on its own. In majority of cases if pain is moderate or of less intensity no treatment is needed. If pain is a concerning cause, warm compresses and mild analgesic and anti inflammatory medicines are beneficial.
However, these medications can only relieve the symptoms but cannot shorten the course of hardening. The hardened cord will takes its own time to resolve. In case if Mondor’s disease has affected penis, patient should cease intercourse for few days or weeks until the lesion has healed completely.