Mondor Disease, Axillary Web Syndrome, Zuska’s Disease and Fat Necrosis

• Mondor’s disease:
  • Is a self-limiting superficial thrombophlebitis of the breast
  • The etiology is not always clear:
    • But it has been reported to be associated with:
      • Trauma
      • Core biopsy
      • Breast surgery
      • Cancer
      • Radiation treatment
      • Underwire bras
      • Oral contraceptives
  • It typically presents as a:
    • Vertically oriented, tender cord on the breast:
      • Which becomes more prominent when the arm is raised and can be associated with skin retraction
  • It can be treated with:
    • Warm compresses
    • Aspirin, or non-steroidal anti-inflammatory drugs:
      • It usually resolves within 4 to 6 weeks
• Axillary web syndrome:
  • Can also present as a palpable cord, but is often found in the axilla:
    • Can extend to involve the medial aspect of the ipsilateral arm down to the antecubital fossa
  • It is associated with limitations in shoulder mobility
• Fat necrosis:
  • Can cause a palpable mass with skin retraction:
    • But it does not generally conform to the distribution of a superficial vein
• Zuska’s disease:
  • Is a condition consisting of:
    • Chronic subareolar abscesses and fistulae
  • Caused by squamous metaplasia and keratin plugging of the breast ducts, and it is not related to Mondor’s disease
• References
  • Pasta V, D’Orazi V, Sottile D, Del Vecchio L, Panunzi A, Urciuoli P. Breast Mondor’s disease: diagnosis and management of six new cases of this underestimated pathology. Phlebology. 2015;30(8):564-568.
  • Salemis NS, Vasilara G, Lagoudianakis E. Mondor’s disease of the breast as a complication of ultrasound-guided core needle biopsy: management and review of the literature. Breast Dis. 2015;35(1):73-76.
  • Shetty MK, Watson AB. Mondor’s disease of the breast: sonographic and mammographic findings. AJR Am J Roentgenol. 2001;177(4):893-896.
  • Tilley A, Thomas-MacLean R, Kwan W. Lymphatic cording or axillary web syndrome after breast cancer surgery. Can J Surg. 2009;52(4):E105-E106.
  • Lannin DR. Twenty-two year experience with recurring subareolar abscess and lactiferous duct fistula treated by a single breast surgeon. Am J Surg. 2004;188(4):407-410.

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