Linda C. Kelahan, MD

44-year-old female presents with “cord-like,” palpable lump on left breast.

First two images represent color Doppler images of the left breast at the 4:00 position.

Second two images represent color Doppler images in the left breast 4:00 position one month after initial presentation.

Superficial thrombophlebitis (Mondor’s disease)

Diagnosis: Superficial thrombophlebitis (Mondor's disease)


Superficial thrombophlebitis of the breast, also known as “Mondor’s disease” is thrombosis of a superficial anterior chest wall vein, commonly involving the lateral thoracic veins, or branches of the external jugular or epigastric veins.

The cause is thought to be idiopathic, but also seen in the setting of breast trauma and surgery, as well as in the setting of breast cancer, although a direct correlative link to breast cancer is not established.

Treatment is conservative, similar to superficial thrombophlebitis elsewhere in the body and does not require anticoagulation.

Ultrasound evaluation usually reveals a superficial vein without flow on Doppler interrogation, which may demonstrate a “beaded” appearance. Echogenic intraluminal thrombus and/or venous luminal expansion may or may not be present on grayscale images. In our case, ultrasound follow-up was performed one month after and demonstrated recanalized venous blood flow.

Such follow-up is helpful, especially in cases where the diagnosis is uncertain, since sonographic or mammographic findings can be suggestive of a dilated duct. In our case, the thrombosed vein was mammographically occult, but has classically been described as presenting on mammography as a superficial tubular density. Mondor’s disease is a benign entity, assigned a BI-RADS category 3, with follow-up imaging recommended.

1. Catania S, Zurrida S, Veronesi P, Galimberti V, Bono A, Pluchinotta A. Mondor's disease and breast cancer. 

2. Shetty MK, Watson AB. Mondor's disease of the breast: sonographic and mammographic findings. 

Linda C. Kelahan, MD

Articles

Image IQ: 44-year-old Female, Cord-Like Breast Lump