The Effectiveness of Diclofenac Sodium in the Treatment of Mondor's Disease of the Breast: The Topical Patch Compared to the Oral Capsules

Abstract

Mondor's disease of the breast is a rare, benign sclerosing superficial thrombophlebitis of the subcutaneous veins of the anterior or lateral chest wall, which is treated conservatively. We aim in this study to evaluate the outcome and effectiveness of our treatment protocol using oral diclofenac sodium and topical diclofenac sodium patch in 172 patients. A retrospective database analysis of 172 female patients between January 2001 and December 2010 was done. The treatment protocol consisted of group 1: treatment by oral diclofenac sodium 100 mg once daily for 3 weeks. Group 2: treatment by diclofenac sodium patches for 8 hours twice daily (morning and evening) for 1 week. The patients were instructed to document the time as soon as pain relief is achieved following the patch application and the intake of the oral dose. The incidence rate was 2.49%. Diclofenac sodium patch was statistically found to be significantly better in subsiding the inflammatory process of the veins, relieving the pain, and enhancing faster healing rate. We conclude that diclofenac sodium patch showed a promising role in the treatment of Mondor's disease of the breast by significantly decreasing the inflammatory process due to its transdermal migration action within a short period and the ability to reach a high local concentration. It achieved the best results for rapid relief of pain and disease regression compared to the oral capsules. Therefore, our protocol was changed to implement diclofenac sodium patch as the first choice in treating Mondor's disease of the breast.

Mondor’s Disease: A Rare Cause of Chest Pain in the Emergency Department

“…Recommendations for the treatment of superficial thrombophlebitis more broadly do include four weeks of low molecular weight heparin as per the American College of Chest Physicians, and while cases of such an approach to Mondor's disease specifically do exist, treatment is typically more conservative [13]. For female patients with Mondor's disease of the breast, topical diclofenac sodium patches have been used to inhibit prostaglandin-mediated inflammation [14]. When it is located in the axillary region, it may also be possible to manually disrupt the fibrosis with applied pressure [3].…”

The dorsal skinfold chamber: A valuable model for the in vivo evaluation of topical formulations

“…Accordingly, the COX inhibitor is meanwhile contraindicated in patients with heart diseases, such as congestive heart failure . On the other hand, topically applied diclofenac formulations are beneficial in the management of superficial vein thrombosis and peripheral thrombophlebitis . In fact, in certain settings diclofenac formulations exhibited anti‐inflammatory and anti‐thrombotic effects.…”

Mondor’s disease of the breast concerning two cases collected in the Senology unit of the Gynecological and Obstetric Clinic of Aristide Le Dantec Hospital

“…Mondor's Disease (MD) of the breast is characterized by superficial sclerosing thrombophlebitis of the subcutaneous veins of the anterior or lateral thoracic wall first described in 1939 by Henry Mondor. It generally involves one of this three veins: lateral thoracic, superior epigastric or thoracoepigastric (the most common) [1]. It has also been described in the arm, abdomen or penis [1,2].…”

“…It generally involves one of this three veins: lateral thoracic, superior epigastric or thoracoepigastric (the most common) [1]. It has also been described in the arm, abdomen or penis [1,2]. Its etiopathogenesis is not clearly defined.…”

“…Referring to the few cases described in the literature, the development of this pathology would be reported after intense physical activity, pregnancy, trauma, surgical intervention (breast reconstruction, breast biopsy, oncological surgery, etc.) and various diseases (neoplasia , breast infection, inflammatory process) [1,2,3].…”