Background: Mondor’s disease (MD) in women is characterized by thrombophlebitis of the breast or anterior chest wall. Hormone therapy,breast cancer,thrombophilic conditions,surgery or traumas, have been identified as etiological factors, but mostly it is idiopathic.Anti-inflammatory and anticoagulant drugs are used in the treatment.
Aims: The aim of our study was to analyze the MD cases followed by our Center to underline any etiological correlation with congenital or acquired thrombophilia and to verify the efficacy of the anticoagulant treatment.
Methods: We examined the medical records of two women (52 and 44 aged), with MD, followed by our center because under anticoagulation. They underwent research of thrombophilia, breast cancer and autoimmune diseases.
Results:
Echocolordoppler of right axillary vascular district shows good reperfusion under anticoagulant therapy in the first patientFig.1
Patients were subjected to specialist and radiological examinations of breast and were found negative for breast cancer.The first,with a thoraco-mammary right thrombophlebitis,had fibromyalgia and had undergone thyroidectomy for thyroiditis several years before.No thrombophilia was found.She was treated with warfarin for six months,but after 8 months direct oral anticoagulants were resumed for lower limb thrombophlebitis.The second patient had an axillary left vein thrombophlebitis;she reported recurrent unexplained abortions and a benign breast fibroadenoma.The research of thrombophilia showed heterozygosis for Factor V Leiden.She was treated first with enoxaparin for a month,then with sulodexide twice daily for 2 weeks until the symptomatology remitted; now she is on sulodexide daily to prevent thrombosis recurrence.
Left axillary vein reconstruction in breast Magnetic Resonance Imaging with contrast evidences the stop sign due to thrombosis (second patient)Fig.2
Conclusions: Our experience, although limited to only two cases,seems to confirm the well known variability of the causes associated with the onset of MD, as well as symptoms and treatments. Although we found a thrombophilic condition in only one patient, in our opinion, the presence of congenital or acquired prothrombotic defects should be always investigated in MD patients for a better choice and duration of the anticoagulant treatment. In any case, periodic follow-up checks with Haemostasis and Breast Specialists are needed for a safe and effective MD management.
To cite this abstract in AMA style:
Sottilotta G, Fava MG, Turano L, Luise F, Nicolo' GM, Oriana V, Piromalli A. Management of Anticoagulation Therapy in Patients with Idiopathic Mondor’s Disease [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/management-of-anticoagulation-therapy-in-patients-with-idiopathic-mondors-disease/. Accessed June 25, 2022.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/management-of-anticoagulation-therapy-in-patients-with-idiopathic-mondors-disease/