Fibromatosis is an infiltrative proliferation of fibroblastic and myofibroblastic cells with significant risk for local recurrence, but no metastatic potential.1 It originates mainly from the fascia or aponeuroses of the abdominal wall muscles or from the muscles of the shoulders and pelvic girdles.1 Fibromatosis is uncommon in the mammary gland and accounts for less than 0.2% of all primary breast lesions.2,3 Although several series of this condition have been reported in women, mammary fibromatosis in men is extremely rare. [4][5][6][7] Despite its rarity, this condition may mimic primary breast malignancy. In cases where suspicious breast findings do not correlate with the usual diagnostic measures, such as those from fine-needle aspiration or core needle biopsy, the diagnosis of a fibromatosis mimicking breast cancer should be considered in the differential diagnosis. [8][9] We report the case of a 47-year-old man with mammary fibromatosis. To the best of our knowledge, this is the sixth case of fibromatosis reported in the male breast. [4][5][6][7] The optimal management of breast fibromatosis in men is unknown because of the rarity of the disease. A review of articles published on breast fibromatosis was performed using the PUBMED-MEDLINE database with emphasis on articles published during the last 10 years. CASE REPORTWe present the case of a 47-year-old man who was admitted to the Outpatient Breast Oncology Service, Department of Health of São Carlos, Brazil, with a 3-month history of a painless subcutaneous mass with rapid growth. Clinical examination revealed an ill-defined mass located in the upper inner quadrant of his left breast tissue measuring of 3.5 cm in diameter. The mass was firm and was fixed to the pectoral fascia and to skin. There was no axillary or cervical lymphadenopathy or nipple discharge.At ultrasound, the lesion manifested as an irregular, hypoechoic mass with posterior acoustic shadowing, suggestive of malignancy. Fine-needle aspiration cytology was performed, but the result was inconclusive because the aspirate did not yield sufficient epithelial cells for diagnosis. The tumor was removed by en bloc resection with wide excision, the greater pectoral muscle being spared. During surgery the lesion was found to be firmly adherent to the underlying pectoralis major. The appearance was that of an infiltrative tumor, and the diagnosis of epithelial neoplasm was considered in the differential diagnosis. There was no history of trauma to the chest wall, so that a fibrous reaction to trauma was not considered in the differential diagnosis.The surgical specimen was fixed in 4% formalin. Sequential 3-mm sections were obtained throughout the specimen. Representative samples of the tumor were embedded in paraffin, and histological sections of 4 µm obtained from the paraffin-embedded blocks were stained with hematoxylin-eosin. The histological sections stained with hematoxylin-eosin showed a proliferation of spindle cells without atypia forming sweeping or interlacing fascicles (Figure 1). The...

Depression in cancer patients is common and may affect treatment outcome either directly (by lowering defenses) or indirectly (by lowering compliance). Neoadjuvant chemotherapy for advanced uterine cervix or breast cancer is a strenuous undertaking and may lead to depression and impair patients' willingness to comply with the rest of the treatment (eg, surgery or radiotherapy). We compare Beck Depression Inventory (BDI) scores both before and after neoadjuvant chemotherapy in order to verify if depression influences treatment outcome. We studied 22 advanced uterine cervix and 20 breast cancer patients submitted to three courses of neoadjuvant chemotherapy. We used cisplatin and ifosfamide for cervix, and fluorouracil, adriamycin, and cyclophosphamide for breast cancer. We did not identify significant differences in the number of depressed patients, before and after treatment. Cognitive affective, somatic-performance, and total BDI scores were not significantly different from before to after chemotherapy for both breast and uterine cervix cancer. After treatment, the number of depressive breast cancer patients increased while the number of uterine cervix cancer patients decreased. This trend to depression was found more often in less responsive breast cancer patients than in the more responsive cervix cancer patients. We were not able to link depression to treatment failure or success, but patients who responded to treatment were less depressed at the end of treatment.

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