What is the pathophysiology of Mondor disease?

Updated: Apr 28, 2020
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Answer

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. [6] An tight bra may be implicated by causing direct trauma. [7] Bodybuilders using intense thoracoabdominal exercise training may also develop it. [8]

Mondor disease may only involve one or more of three 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. [9, 10]

Although most often linked with breast cancer surgery and anesthetic mammaplasties, [11] it may also occur as a result of excision of axillary nodes after gel silicone breast implant rupture. [12] It may also be a complication of ultrasound-guided core needle biopsy. [13] Trauma from breast augmentation was described as a predisposing factor. [14]  Hypersensitivity reactions may also predispose, with penile Mondor disease rarely linked with scabies. [15]


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