A 30-year-old woman noticed a painful cord-like band in the lower outer quadrant of her right breast two weeks ago. On examination there is a palpable subcutaneous cord that becomes prominent and produces a skin furrow when she raises her arm. There is no discrete lump and mammography is normal. What is the most appropriate management?
- A Reassurance and simple analgesia, since the condition is self limiting ✓
- B Therapeutic anticoagulation for three months
- C Wide local excision of the cord with histopathological examination
- D Core biopsy of the cord to exclude malignancy
Correct answer: A. Reassurance and simple analgesia, since the condition is self limiting
Explanation
This is Mondor disease, a superficial thrombophlebitis of the thoracoepigastric or lateral thoracic veins presenting as a tender subcutaneous cord with skin retraction on arm elevation. It is benign, resolves spontaneously over four to six weeks, and needs only analgesia. Anticoagulation is unnecessary because the thrombosis is superficial and localised, which eliminates B, and normal imaging plus typical signs exclude the need for excision.
Reference: Schwartz's Principles of Surgery, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.