Mondor's disease: Difference between revisions

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==Overview==
 
'''Mondor's disease''' is a rare condition which involves [[thrombophlebitis]] of the superficial [[vein]]s of the [[breast]] and anterior chest wall. It sometimes occurs in the [[arm]] or penis.
'''Mondor's disease''' is a rare condition which involves [[thrombophlebitis]] of the superficial [[vein]]s of the [[breast]] and anterior chest wall. It sometimes occurs in the [[arm]] or penis.


==Historical Perspective==
It is named after Henri Mondor (1885-1962), a [[surgery|surgeon]] in Paris, France who first described the disease in 1939.
It is named after Henri Mondor (1885-1962), a [[surgery|surgeon]] in Paris, France who first described the disease in 1939.
==Differentiating Mondor's Disease from other Diseases==
Mondor's disease must be differentiated from other diseases that cause [[breast pain]] and [[swelling]].
<small>'''ABBREVIATIONS'''<br>LAP=Lymphadenopathy, HRT=Hormonal replacement therapy, FNA=Fine needle aspiration, DCIS=Ductal carcinoma in-situ</small>
<small>
{|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" rowspan="3" |Diseases
! style="background: #4479BA; color: #FFFFFF; text-align: center;" rowspan="3" |Benign or
Malignant
! style="background: #4479BA; color: #FFFFFF; text-align: center;" colspan="8" |Clinical manifestation
! style="background: #4479BA; color: #FFFFFF; text-align: center;" colspan="2" |Paraclinical findings
! style="background: #4479BA; color: #FFFFFF; text-align: center;" rowspan="3" |Gold standard diagnosis
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" rowspan="2" |Demography
! style="background: #4479BA; color: #FFFFFF; text-align: center;" rowspan="2" |History
! style="background: #4479BA; color: #FFFFFF; text-align: center;" colspan="3" |Symptoms
! style="background: #4479BA; color: #FFFFFF; text-align: center;" colspan="3" |Signs
! style="background: #4479BA; color: #FFFFFF; text-align: center;" rowspan="2" |Histopathology
! style="background: #4479BA; color: #FFFFFF; text-align: center;" rowspan="2" |Imaging
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Mass
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Mastalgia
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nipple discharge
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Breast exam
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Skin changes
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |LAP
|-
! align="center" style="background:#DCDCDC;" |[[Fibroadenoma]]
| align="left" style="background:#F5F5F5;" |
* [[Benign]]
* Very slight increased risk of [[breast cancer]] in complex [[fibroadenoma]]
| align="left" style="background:#F5F5F5;" |
* Most common [[benign]] [[tumor]], women aged 20-30 years
| align="left" style="background:#F5F5F5;" |
* Increases in size during [[pregnancy]] or with [[estrogen]] therapy, and regress after [[menopause]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Solitary
* Well-defined
* Mobile mass
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Proliferative [[breast]] lesion without [[atypia]]
| align="left" style="background:#F5F5F5;" |[[Ultrasound]]:
* Well-defined
* Solid mass
| align="left" style="background:#F5F5F5;" |
* [[Mammography]] 
* [[Ultrasound]] 
* [[Biopsy]]
|-
! align="center" style="background:#DCDCDC;" |[[Breast]] [[cyst]]
| align="left" style="background:#F5F5F5;" |
* [[Benign]]
* No increased risk of [[malignancy]] for simple [[cyst]]
* <1% for complicated [[cyst]]
* <1% to 23% for complex [[cyst]]
| align="left" style="background:#F5F5F5;" |
* Common masses found in [[premenopausal]], [[perimenopausal]], and [[postmenopausal]] women
* Mostly seen among [[HRT]] users
| align="left" style="background:#F5F5F5;" |
* May resolve after aspiration
* Further evaluation for unresolved masses
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Solitary
* Cluster of small masses or an ill-defined mass
* Smooth, firm, and frequently [[Tenderness|tender]]
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Nonproliferative [[breast]] lesions
| align="left" style="background:#F5F5F5;" |[[Ultrasound]]:
* Simple [[cyst]]: Well circumscribed, posterior acoustic enhancement without internal echoes
* Complicated [[cyst]]: Homogenous low-level internal echoes due to without solid components
* Complex [[cyst]]: Thick walls greater than 0.5 mm with solid component
| align="left" style="background:#F5F5F5;" |
* [[Ultrasound]]
* [[Fine needle aspiration]] ([[FNA]])
|-
! align="center" style="background:#DCDCDC;" |Fibrocystic change
| align="left" style="background:#F5F5F5;" left" |
* [[Benign]]
* No increased risk of [[malignancy]]
* Slightly increased risk of [[malignancy]] in presence of positive [[familial history]] of [[breast cancer]]
| align="left" style="background:#F5F5F5;" |
* Unknown prevalence among adolescents
* >50% in women of reproductive age
| align="left" style="background:#F5F5F5;" |
* Present before menses and improve during [[menstruation]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |±
| align="left" style="background:#F5F5F5;" |
* Painful [[breast]] tissue
* Tender, [[nodular]] swelling
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Nonproliferative [[breast]] lesions
| align="left" style="background:#F5F5F5;" |[[Ultrasound]]:
* Small [[cysts]] in [[mammary]] zone
* Fibroglandular tissue around the mass
| align="left" style="background:#F5F5F5;" |
* [[Ultrasound]]
* [[Mammography]] (it is not recommended for adolescents)
|-
! align="center" style="background:#DCDCDC;" |[[Galactocele]]
| align="left" style="background:#F5F5F5;" |
* [[Benign]]
* No increased risk of [[malignancy]]
| align="left" style="background:#F5F5F5;" |
* Milk retention [[cysts]] with fluid collection among [[pregnant]] women and during [[breast-feeding]]
| align="left" style="background:#F5F5F5;" |
* After ending [[lactation]], the [[cysts]] resolve
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" |±
| align="left" style="background:#F5F5F5;" |
* Soft masses
* [[Cystic]] masses
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* [[Inflammation]] of lactate ducts due to extension, results in wall [[fibrosis]]
| align="left" style="background:#F5F5F5;" |[[Mammography]]:
* Intermediate mass in absence of classic fat-fluid level
[[Ultrasound]]:
* Complex mass
| align="left" style="background:#F5F5F5;" |
* [[Ultrasound]]
* [[Mammography]]
|-
! align="center" style="background:#DCDCDC;" |[[Cysts]] of [[Glands of Montgomery|montgomery]]
| align="left" style="background:#F5F5F5;" |
* [[Benign]]
* No increased risk of [[malignancy]]
| align="left" style="background:#F5F5F5;" |
* Most common in age of 10-20 years old
| align="left" style="background:#F5F5F5;" |
* More than 80% resolve spontaneously
* Drainage is essential in rare cases
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" |±
| align="left" style="background:#F5F5F5;" |
* Asymptomatic subareolar mass
* Drainage of clear to brownish fluid
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* [[Acute]] [[inflammation]] due to [[obstruction]] of the [[Montgomery's glands|Montgomery's gland]]
| align="left" style="background:#F5F5F5;" |[[Ultrasound]]:
* Single [[cystic]] lesion in retroareolar area
| align="left" style="background:#F5F5F5;" |
* [[Ultrasound]]
|-
! align="center" style="background:#DCDCDC;" |[[Hemangioma|Hamartoma]]
| align="left" style="background:#F5F5F5;" |
* [[Benign]]
* Coexisting [[malignancy]] may be present
| align="left" style="background:#F5F5F5;" |
* Common in women older than 35 years old
| align="left" style="background:#F5F5F5;" |
* [[Asymptomatic]] ones found incidentally or painless [[breast lump]]
* Usually excised
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Soft [[breast lump]]
* [[Breast]] enlargement without palpable mass
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* [[Benign]] proliferation of [[fibrous]], [[glandular]], and fatty tissue
* Thin capsule of [[connective tissue]]
| align="left" style="background:#F5F5F5;" |[[Mammography]]:
* Well-described
* Discrete, solid, and encapsulated lesion
| align="left" style="background:#F5F5F5;" |
* [[Ultrasound]]
* [[Mammography]]
|-
! align="center" style="background:#DCDCDC;" |[[Breast abscess]]
| align="left" style="background:#F5F5F5;" |
* [[Benign]]
* No increased risk of [[malignancy]]
| align="left" style="background:#F5F5F5;" |
* Complication of lactational [[mastitis]] in 14% of cases
* Common among African-American women, heavy smokers , and [[obese]] patients
| align="left" style="background:#F5F5F5;" |
* Resolve after drainage/[[antibiotic therapy]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Localized [[inflammation]] of [[breast]]
* [[Tenderness]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Mixed [[inflammatory]] feature by [[neutrophils]].
* [[Granulation tissue]] and [[chronic]] [[inflammation]] feature caused by  [[Gram-positive cocci]]
| align="left" style="background:#F5F5F5;" |[[Ultrasound]]:
* Fluid collection
| align="left" style="background:#F5F5F5;" |
* [[Ultrasound]]
|-
! align="center" style="background:#DCDCDC;" |[[Mastitis]]
| align="left" style="background:#F5F5F5;" |
* [[Benign]]
* No increased risk of [[malignancy]]
| align="left" style="background:#F5F5F5;" |
* Common among lactating women (first three months of [[breast-feeding]])
* Periductal [[mastitis]] among smokers and associated with [[squamous]] [[metaplasia]]
| align="left" style="background:#F5F5F5;" |
* Resolve after drainage/[[antibiotic therapy]]
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |±
| align="left" style="background:#F5F5F5;" |
* [[Breast]] [[tenderness]]
* Swollen [[breast]] [[tissue]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |[[Breast]] [[parenchyma]]    [[inflammation]]:
* [[Acute]] [[mastitis]]: [[Staphylococcus]] [[infection]]
* [[Granulomatous]] [[mastitis]]: [[Tuberculosis]] or [[sarcoidosis]] [[infection]]
| align="left" style="background:#F5F5F5;" |[[Ultrasound]]:
* Ill-defined area with hyperechogenicity with inflamed fat lobules
* Skin thickening
| align="left" style="background:#F5F5F5;" |
* [[Ultrasound]]
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Benign or<br>Malignant
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Mass
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Mastalgia
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nipple discharge
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Breast exam
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Skin changes
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |LAP
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard diagnosis
|-
! align="center" style="background:#DCDCDC;" |[[Breast carcinoma]]
| align="left" style="background:#F5F5F5;" |
* [[Malignant]]
| align="left" style="background:#F5F5F5;" |
* Most common diagnosed [[cancer]] among women
* Leading cause of cancer death in women 40-49 years old
| align="left" style="background:#F5F5F5;" |
* Positive [[family history]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |±
| align="left" style="background:#F5F5F5;" |
* Hard
* Immobile
* Solitary
* Irregular margin
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" |±
| align="left" style="background:#F5F5F5;" |
* Molecular alteration in [[epithelial cells]]
* Ductal
* [[Lobular]]
* Ductal/lobular
* [[Mucinous]]
* [[Tubular]]
* [[Medullary]]
* [[Papillary]]
| align="left" style="background:#F5F5F5;" |[[Mammography]]:
* Spiculated soft tissue, mass [[microcalcification]]
[[Ultrasound|Ultrasound:]]
* Spiculated, hypoechoic lesion, shadowing, internal [[calcification]]
| align="left" style="background:#F5F5F5;" |
* [[Ultrasound]]
* [[Mammography]]
|-
! align="center" style="background:#DCDCDC;" |[[Ductal carcinoma in situ]] ([[DCIS]])
| align="left" style="background:#F5F5F5;" |
* [[Malignant]]
| align="left" style="background:#F5F5F5;" |
* Approximately 25% of all [[Breast Cancer|breast cancers]]
* Increase risk with [[ageing]]
| align="left" style="background:#F5F5F5;" |
* Positive [[family history]]
* Nulliparity
* [[Obesity]]
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |±
| align="left" style="background:#F5F5F5;" |
* May have normal physical exam
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Noninvasive [[breast cancer]]
* Heterogenous group of [[neoplastic]] lesions
| align="left" style="background:#F5F5F5;" |[[Mammography|Mammography:]]
* Suspicious [[microcalcification]]
| align="left" style="background:#F5F5F5;" |
* [[Mammography]]
|-
! align="center" style="background:#DCDCDC;" |Microinvasive [[breast cancer]]
| align="left" style="background:#F5F5F5;" |
* [[Malignant]]
| align="left" style="background:#F5F5F5;" |
* Rare
* Commonly referred to [[DCIS]] with microinvasion
* Average age 50-60 years old
| align="left" style="background:#F5F5F5;" |
* Nulliparity
* Positive [[family history]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |±
| align="left" style="background:#F5F5F5;" |
* Solitary
* Firm palpable mass
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |±
| align="left" style="background:#F5F5F5;" |
* Associated with high grade [[DCIS]]
| align="left" style="background:#F5F5F5;" |[[Mammography]]:
* A mass with or without [[calcification]]
* Stromal reaction
| align="left" style="background:#F5F5F5;" |
* [[Mammography]]
|-
! align="center" style="background:#DCDCDC;" |[[Breast]] [[sarcoma]]
| align="left" style="background:#F5F5F5;" |
* [[Malignant]]
| align="left" style="background:#F5F5F5;" |
* Rare type, < 1% of all breast malignancies
* Average age of between 45-50 years
| align="left" style="background:#F5F5F5;" |
* Positive history of [[breast cancer]]
* Rapid increase in size
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Well-defined
* Firm mass
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Heterogeneous nonepithelial malignancies from [[connective tissue]] of breast
| align="left" style="background:#F5F5F5;" |[[Mammography]]:
* Noncalcified oval mass Indistinct margins
| align="left" style="background:#F5F5F5;" |
* [[Mammography]]
|-
! align="center" style="background:#DCDCDC;" |[[Phyllodes tumor]]
| align="left" style="background:#F5F5F5;" |
* [[Benign]] or
* [[Malignant]]
| align="left" style="background:#F5F5F5;" |
* Most common in [[premenopausal]] women (40-50 years)
| align="left" style="background:#F5F5F5;" |
* Represent 1% of breast tumors
* Grow aggressively
* Classify in [[benign]], [[borderline]], and [[malignant]] groups
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Smooth and multinodular
* Well-defined
* Firm mass
* Mobile
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Nonepithelial breast [[neoplasm]] with average size of 5 cm
| align="left" style="background:#F5F5F5;" |[[Ultrasound]]:
* Solid mass
* Hypoechoic
* Well-circumscribed
[[Mammography]]:
* Smooth mass
* Polylobulated mass
| align="left" style="background:#F5F5F5;" |
* [[Ultrasound]]
* [[Mammography]]
|-
! align="center" style="background:#DCDCDC;" |[[Lymphoma]]
| align="left" style="background:#F5F5F5;" |
* [[Malignant]]
| align="left" style="background:#F5F5F5;" |
* Extremely rare ( 0.04%-0.5%)
* Average age 55-60 years
| align="left" style="background:#F5F5F5;" |
* Unilateral mass in older women
* In childbearing women, bilateral and similar to [[inflammatory]] [[breast cancer]], possibly having [[Burkitt lymphoma]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Well-defined, firm mass
* Multiple
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |±
| align="left" style="background:#F5F5F5;" |
* Diffuse growth pattern with large cells like [[immunoblast]] associated with [[neutrophils]]
| align="left" style="background:#F5F5F5;" |[[Mammography]]:
* Nonspecific circumscribed masses
* Without [[calcification]]
| align="left" style="background:#F5F5F5;" |
* [[Mammography]]
* Core [[biopsy]]
|-
! align="center" style="background:#DCDCDC;" |[[Duct ectasia]]
| align="Left" style="background:#F5F5F5;" |
* [[Benign]]
| align="left" style="background:#F5F5F5;" |
* Common among [[perimenopausal]] women
| align="left" style="background:#F5F5F5;" |
* Usually resolve spontaneously
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" |±
| align="left" style="background:#F5F5F5;" |
* Usually asymptomatic
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Distention of subareolar ducts
| align="left" style="background:#F5F5F5;" |[[Ultrasound]]:
* Dilated milk ducts
* Fluid-filled ducts
| align="left" style="background:#F5F5F5;" |
* [[Ultrasound]]
|-
! align="center" style="background:#DCDCDC;" |Intraductal [[papilloma]]
| align="left" style="background:#F5F5F5;" |
* [[Benign]]
| align="left" style="background:#F5F5F5;" |
* Common in women between 35-55 years old
| align="left" style="background:#F5F5F5;" |
* Possibly [[benign]]
* Harbor areas of [[atypia]] or [[DCIS]]
* Surgical [[excision]] is recommended
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" |±
| align="left" style="background:#F5F5F5;" |
* Solitary or multiple lesion
* Large lump near nipple
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Growth of papillary cell into a lumen
| align="left" style="background:#F5F5F5;" |[[Ultrasound]]:
* Well-defined
* Solid nodule
| align="left" style="background:#F5F5F5;" |
* Core needle [[biopsy]]
|-
! align="center" style="background:#DCDCDC;" |[[Lipoma]]
| align="left" style="background:#F5F5F5;" |
* [[Benign]]
| align="left" style="background:#F5F5F5;" |
* Common between age of 40-60 years old
| align="left" style="background:#F5F5F5;" |
* [[Benign]] tumors
* May experience recurrence
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Solitary
* Mobile
* Soft mass
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Mature [[adipocytes]] without lipoblasts or [[atypia]]
| align="left" style="background:#F5F5F5;" |[[Ultrasound]]:
* Well-Circumscribed
* Hypoechoic lesion
| align="left" style="background:#F5F5F5;" |
* Core needle [[biopsy]]
* Excisional [[biopsy]]
|
|-
! align="center" style="background:#DCDCDC;" |[[Sclerosing adenosis]]
| align="left" style="background:#F5F5F5;" |
* Small risk of [[malignancy]]
| align="left" style="background:#F5F5F5;" |
* Recurrent pain during mensturation
| align="left" style="background:#F5F5F5;" |
* May present as a mass or incidental finding on [[mammogram]]
* No treatment is needed
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Multiple lesion
* Firm
* Tender nodules
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Proliferative disease
| align="left" style="background:#F5F5F5;" |[[Mammography]]:
* Well-defined or irregular mass
* [[Microcalcification]]
| align="left" style="background:#F5F5F5;" |
* [[Mammography]]
| align="center" style="background:#F5F5F5;" |
|-
| align="center" style="background:#DCDCDC;" |'''Pseudoangiomatous stromal hyperplasia'''
| align="left" style="background:#F5F5F5;" |
* [[Benign]]
| align="left" style="background:#F5F5F5;" |
* Common in reproductive age women
| align="left" style="background:#F5F5F5;" |
* [[Benign]] stromal [[proliferation]]
* Stimulation of vascular lesion
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Solitary firm mass
* Thickening
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Slit-like spaces between [[glandular]] units 
* Maybe confused with mammary [[angiosarcoma]]
| align="left" style="background:#F5F5F5;" |[[Mammography]] and [[ultrasound]]:
* Well-defined
* Solid mass
* Noncalcified
| align="left" style="background:#F5F5F5;" |
* [[Ultrasound]]
* [[Mammography]]
|-
| align="center" style="background:#DCDCDC;" |'''[[Mondor's disease]]'''
| align="left" style="background:#F5F5F5;" |
* [[Benign]]
| align="left" style="background:#F5F5F5;" |
* Uncommon [[benign]] disease
* Occur on outer side of [[breast]] or under [[nipple]]
| align="left" style="background:#F5F5F5;" |
* [[Benign]] and self-limiting disease
* Resolve after 4-6 weeks
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Thick and tender cord on breast skin
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* N/A
| align="left" style="background:#F5F5F5;" |[[Ultrasound]]:
* [[Tubular]] anechoic structure
* Multiple narrowing areas
| align="left" style="background:#F5F5F5;" |
* Clinical examination
* [[Ultrasound]]
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Benign or<br>Malignant
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Mass
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Mastalgia
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nipple discharge
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Breast exam
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Skin changes
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |LAP
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard diagnosis
|-
| align="center" style="background:#DCDCDC;" |'''[[Diabetic]] mastopathy'''
| align="left" style="background:#F5F5F5;" |
* [[Benign]]
| align="left" style="background:#F5F5F5;" |
* [[Lymphocytic]] [[mastitis]] or mastopathy
* Common among [[premenopausal]] women
* Longstanding [[diabetes mellitus type 1]]
| align="left" style="background:#F5F5F5;" |
* Suspicious breast mass
* After [[diagnosis]], excision is not required
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Ill-defined mass
* Immobile
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Dense keloid-like [[fibrosis]]
* Periductal, lobular, and perivascular [[lymphocytic]] [[Infiltration (medical)|infiltration]]
| align="left" style="background:#F5F5F5;" |[[Ultrasound]]:
* Irregular mass
* Hypoechoic
* Dense lesion
| align="left" style="background:#F5F5F5;" |
* [[Ultrasound]]
* Core needle [[biopsy]]
|-
! align="center" style="background:#DCDCDC;" |[[Gynecomastia]]
| align="left" style="background:#F5F5F5;" |
* [[Benign]]
| align="left" style="background:#F5F5F5;" |
* Benign breast tissue swelling among men and boys around [[puberty]]
| align="left" style="background:#F5F5F5;" |
* [[Benign]] [[proliferation]] of the male breast [[glandular tissue]]
* Usually underlying nipple mass
* At least 0.5 cm
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" |±
| align="left" style="background:#F5F5F5;" |
* Unilateral or bilateral firm mass
* Breast swelling
* Rubbery mass
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* [[Glandular]] breast changes
| align="left" style="background:#F5F5F5;" |[[Ultrasound]]:
* [[Nodular]] pattern
* Dendritic pattern
* Diffuse [[glandular]] pattern
| align="left" style="background:#F5F5F5;" |
* [[Ultrasound]]
|-
! align="center" style="background:#DCDCDC;" |[[Sarcoidosis]]
| align="left" style="background:#F5F5F5;" |
* [[Benign]]
| align="left" style="background:#F5F5F5;" |
* Rare in patients with systemic involvement
| align="left" style="background:#F5F5F5;" |
* [[Benign]] palpable mass
* May mimic [[malignancy]] feature
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Firm mass
* Hard mass
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* [[Epithelioid]] [[granulomas]] with multinucleated [[giant cell]] with rare [[necrosis]]
| align="left" style="background:#F5F5F5;" |[[Mammography]]:
* Irregular
* Ill-defined
* Spiculated solid mass
| align="left" style="background:#F5F5F5;" |
* [[Biopsy]]
|-
! align="center" style="background:#DCDCDC;" |[[Fat necrosis]]
| align="left" style="background:#F5F5F5;" |
* [[Benign]]
| align="left" style="background:#F5F5F5;" |
* Common among women
* May mimic [[malignancy]] features
| align="left" style="background:#F5F5F5;" |
* [[Benign]] [[breast lumps]] develop after [[trauma]]/ [[surgery]]
* Suspicious lumps required [[biopsy]]
* No [[excision]] in established diagnosis
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |±
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Hard or smooth mass
* Solitary mass
* Mobile
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="left" style="background:#F5F5F5;" |
* Collections of liquefied fat
| align="left" style="background:#F5F5F5;" |[[Ultrasound]]:
* Collections of liquefied fat
* Oil [[cysts]]
| align="left" style="background:#F5F5F5;" |
* [[Ultrasound]]
|}
</small>


==External links.==  
==External links.==  
*Image: http://www.medcyclopaedia.com/library/topics/volume_iii_2/m/MONDORS_DISEASE.aspx
* Image: http://www.medcyclopaedia.com/library/topics/volume_iii_2/m/MONDORS_DISEASE.aspx
Article: http://www.plasticsurgerypa.com/index.cfm?event=ProductView&CategoryID=45&SubcategoryID=102&ProductID=272
* Article: http://www.plasticsurgerypa.com/index.cfm?event=ProductView&CategoryID=45&SubcategoryID=102&ProductID=272
 
{{SIB}}   


[[Category:Breast]]
[[Category:Breast]]
 
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Latest revision as of 16:56, 22 August 2021

Mondor's disease
ICD-10 I80.8 (ILDS I80.81)
ICD-9 451.89
DiseasesDB 32183
eMedicine derm/909 

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shadan Mehraban, M.D.[2]

Overview

Mondor's disease is a rare condition which involves thrombophlebitis of the superficial veins of the breast and anterior chest wall. It sometimes occurs in the arm or penis.

Historical Perspective

It is named after Henri Mondor (1885-1962), a surgeon in Paris, France who first described the disease in 1939.


Differentiating Mondor's Disease from other Diseases

Mondor's disease must be differentiated from other diseases that cause breast pain and swelling.

ABBREVIATIONS
LAP=Lymphadenopathy, HRT=Hormonal replacement therapy, FNA=Fine needle aspiration, DCIS=Ductal carcinoma in-situ

Diseases Benign or

Malignant

Clinical manifestation Paraclinical findings Gold standard diagnosis
Demography History Symptoms Signs Histopathology Imaging
Mass Mastalgia Nipple discharge Breast exam Skin changes LAP
Fibroadenoma + ±
  • Solitary
  • Well-defined
  • Mobile mass
Ultrasound:
  • Well-defined
  • Solid mass
Breast cyst
  • May resolve after aspiration
  • Further evaluation for unresolved masses
+ ±
  • Solitary
  • Cluster of small masses or an ill-defined mass
  • Smooth, firm, and frequently tender
  • Nonproliferative breast lesions
Ultrasound:
  • Simple cyst: Well circumscribed, posterior acoustic enhancement without internal echoes
  • Complicated cyst: Homogenous low-level internal echoes due to without solid components
  • Complex cyst: Thick walls greater than 0.5 mm with solid component
Fibrocystic change
  • Unknown prevalence among adolescents
  • >50% in women of reproductive age
+ + ±
  • Nonproliferative breast lesions
Ultrasound:
  • Small cysts in mammary zone
  • Fibroglandular tissue around the mass
Galactocele + ± ± Mammography:
  • Intermediate mass in absence of classic fat-fluid level

Ultrasound:

  • Complex mass
Cysts of montgomery
  • Most common in age of 10-20 years old
  • More than 80% resolve spontaneously
  • Drainage is essential in rare cases
+ ± ±
  • Asymptomatic subareolar mass
  • Drainage of clear to brownish fluid
± Ultrasound:
  • Single cystic lesion in retroareolar area
Hamartoma
  • Common in women older than 35 years old
± ± Mammography:
  • Well-described
  • Discrete, solid, and encapsulated lesion
Breast abscess
  • Complication of lactational mastitis in 14% of cases
  • Common among African-American women, heavy smokers , and obese patients
+ + + Ultrasound:
  • Fluid collection
Mastitis ± + ± + Breast parenchyma inflammation: Ultrasound:
  • Ill-defined area with hyperechogenicity with inflamed fat lobules
  • Skin thickening
Diseases Benign or
Malignant
Demography History Mass Mastalgia Nipple discharge Breast exam Skin changes LAP Histopathology Imaging Gold standard diagnosis
Breast carcinoma
  • Most common diagnosed cancer among women
  • Leading cause of cancer death in women 40-49 years old
+ ±
  • Hard
  • Immobile
  • Solitary
  • Irregular margin
± ± Mammography:

Ultrasound:

Ductal carcinoma in situ (DCIS) ± ±
  • May have normal physical exam
Mammography:
Microinvasive breast cancer
  • Rare
  • Commonly referred to DCIS with microinvasion
  • Average age 50-60 years old
+ ±
  • Solitary
  • Firm palpable mass
±
  • Associated with high grade DCIS
Mammography:
Breast sarcoma
  • Rare type, < 1% of all breast malignancies
  • Average age of between 45-50 years
+
  • Well-defined
  • Firm mass
± Mammography:
  • Noncalcified oval mass Indistinct margins
Phyllodes tumor ±
  • Smooth and multinodular
  • Well-defined
  • Firm mass
  • Mobile
  • Nonepithelial breast neoplasm with average size of 5 cm
Ultrasound:
  • Solid mass
  • Hypoechoic
  • Well-circumscribed

Mammography:

  • Smooth mass
  • Polylobulated mass
Lymphoma
  • Extremely rare ( 0.04%-0.5%)
  • Average age 55-60 years
+
  • Well-defined, firm mass
  • Multiple
± Mammography:
Duct ectasia
  • Usually resolve spontaneously
± ± ±
  • Usually asymptomatic
  • Distention of subareolar ducts
Ultrasound:
  • Dilated milk ducts
  • Fluid-filled ducts
Intraductal papilloma
  • Common in women between 35-55 years old
+ ± ±
  • Solitary or multiple lesion
  • Large lump near nipple
  • Growth of papillary cell into a lumen
Ultrasound:
  • Well-defined
  • Solid nodule
Lipoma
  • Common between age of 40-60 years old
  • Benign tumors
  • May experience recurrence
+
  • Solitary
  • Mobile
  • Soft mass
Ultrasound:
  • Well-Circumscribed
  • Hypoechoic lesion
Sclerosing adenosis
  • Recurrent pain during mensturation
  • May present as a mass or incidental finding on mammogram
  • No treatment is needed
± +
  • Multiple lesion
  • Firm
  • Tender nodules
±
  • Proliferative disease
Mammography:
Pseudoangiomatous stromal hyperplasia
  • Common in reproductive age women
+
  • Solitary firm mass
  • Thickening
Mammography and ultrasound:
  • Well-defined
  • Solid mass
  • Noncalcified
Mondor's disease
  • Benign and self-limiting disease
  • Resolve after 4-6 weeks
+ +
  • Thick and tender cord on breast skin
+
  • N/A
Ultrasound:
  • Tubular anechoic structure
  • Multiple narrowing areas
Diseases Benign or
Malignant
Demography History Mass Mastalgia Nipple discharge Breast exam Skin changes LAP Histopathology Imaging Gold standard diagnosis
Diabetic mastopathy
  • Suspicious breast mass
  • After diagnosis, excision is not required
+
  • Ill-defined mass
  • Immobile
Ultrasound:
  • Irregular mass
  • Hypoechoic
  • Dense lesion
Gynecomastia
  • Benign breast tissue swelling among men and boys around puberty
+ ± ±
  • Unilateral or bilateral firm mass
  • Breast swelling
  • Rubbery mass
Ultrasound:
Sarcoidosis
  • Rare in patients with systemic involvement
+
  • Firm mass
  • Hard mass
Mammography:
  • Irregular
  • Ill-defined
  • Spiculated solid mass
Fat necrosis + ±
  • Hard or smooth mass
  • Solitary mass
  • Mobile
  • Collections of liquefied fat
Ultrasound:
  • Collections of liquefied fat
  • Oil cysts


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