Supporting women whose lives have been touched by breast cancer

Mondors Disease

By ll

I was first diagnosed with breast cancer at the age of 37 in 2006 in the right breast after finding a lump myself.

It was about a year after my mum had surgery for breast cancer at age 57 so I think I was just extra vigilant when I found it but because of my age tried to convince myself it would be nothing.

I got a GP appointment and she referred me to the breast unit as it did feel irregular to her but she tried to reassure me saying the referral was because of my mum's history. It was a horrible time as I didn’t want to worry family in case it was nothing.

I was diagnosed following mammogram by reading my results when I was given my file to take to ultrasound. The ultrasound and fine needle aspiration confirmed this on the day and a few days later got the results of the biopsy indicating it was a grade 1 cancer.

I had a WLE with SNB and radioactivity, but unfortunately I had positive margins although the 4 nodes removed were negative. After a further incision 2 weeks later I had clear margins. The cancer was highly oestrogen positive and as it was grade 1 I was informed I wouldn't need chemotherapy just radiotherapy and tamoxifen for 5 years.

Soon after surgery I developed a tightness in my right arm especially when I stretched I was told it was likely to be cording which when the lymphatic vessels become hard and not so flexible. I was constantly taking painkillers and even got an infection in my arm after pricking my finger on a staple. This resulted in me being admitted to hospital with lymphangitis or thrombophlebitis (different doctors said different things) for IV antibiotics for 4 days. The cording continued for a number of months and even physio didn’t improve it much and it gradually diminished.

However it does recur whenever I have had any trauma to my arm like tripping over and breaking a bone in my hand. I also had an episode of cellulitis in my hand from a hang nail which resulted in more antibiotics.

I do also suffer from mild lymphoedema in my hand if I do too much like driving for long periods or peeling loads of veggies.

In May 2009 I was recalled following my routine mammogram and diagnosed with a new primary cancer following ultrasound in my left breast. I was in complete shock as I hadn’t felt a lump until I got the call to say the mammo was unsatisfactory.

Biopsy confirmed a new primary grade 3 tumour and was admitted for WLE, SNB and radioactivity the following day. This was a triple negative basal cell carcinoma, stage 1 grade 3 only 1 node had been removed and it was negative however there was lymphatic invasion and I felt really down that this diagnosis wasn’t as ‘good’ as my first cancer. I knew that being triple negative and grade 3 meant I had a poorer prognosis and higher chance of recurrence.

Over the next few weeks I adjusted to my new diagnosis and came to terms with the fact I had breast cancer AGAIN!

A few weeks after surgery when the swelling reduced I started to notice a dimple in the left breast, not in the area where I had surgery at the top of my breast, but below the nipple. It looked like an indentation, like the skin was tethered within the breast. It wasn’t painful but when I lifted my arm it became very noticeable.

Being breast aware I was really attentive that a sign of breast cancer was a puckering or indentation to the skin. I was seeing my GP who thought it may have been something called Mondor’s Disease but she wasn’t sure and couldn’t rule out another tumour but assured me it was most unlikely so soon after mammogram and surgery. I knew this myself but that niggling doubt in the back of your head really gets to you.

I spoke to my BCN who arranged an appointment to see one of the specialist nurses the following week.

After a very tense weekend the specialist nurse thought it was an area that had been manipulated during surgery but as my consultant was in clinic she asked him to see it.

He took one look and said ‘oh that’s a Mondor’s’. He explained it was like cording but through the breast and is sometimes called sclerosing thrombophlebitis. It can happen as a result of surgery or sometimes it can happen spontaneously. Often the presentation is of the ‘cording’ protruding under the breast but where it runs through the breast it pulls it in creating the indentation. He suggested that some people seem more prone to cording and therefore more susceptible to getting Mondor’s Disease and from my previous history he thought this may have been the case. His advice was to rub in ibuprofen gel and try to stretch the vessels with both hands but that it was mostly like to resolve on its own with time.

It was such a relief to find out that it was a benign condition but had never heard of it prior to this. I have since researched it and discovered it was named after the Parisian surgeon Henri Mondor who identified the disease in 1939. It normally starts with a red, painful area however in my case it was so soon after surgery that any pain would have been mistaken for post operative pain and redness. After the first week or two it changes from tender to painless and the cord can be felt under the skin like a rope or band. In some cases it can be under the breast, through the breast or through the auxilla or a combination of all three. It can limit movement and stretching in a similar way to cording of the arm.

It’s about 5 weeks since I first noticed this dimple and it is now starting to reduce and the indentation is not so deep. It normally disappears completely within about 3 months.

Although it is a benign disorder any changes to the breast are of a concern and it is always best to have them looked at by your GP or at a breast clinic.

There is no increased risk in developing breast cancer if you are diagnosed with Mondor’s Disease either although any breast surgery, trauma or infection can initiate it.

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