ASCO 2012: Breast Cancer Outcomes among HIV Positive Women

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Women with HIV can do well on a variety of different types of treatment for breast cancer, but they are prone to infections and blood cell deficiencies and may benefit from adjunct therapies, researchers reported at the American Society of Clinical Oncology Annual Meeting (ASCO 2012) taking place this week in Chicago.

As people with HIV live longer thanks to effective antiretroviral therapy (ART), they have more time to develop malignancies. Breast cancer is generally not one of the non-AIDS cancers that have been found to occur more frequently among HIV positive compared with HIV negative people, but HIV positive women share the high risk of the population at large.

Roberto Enrique Ochoa and colleagues performed a retrospective review of breast cancer cases in HIV positive patients seen at the University of Miami Sylvester Comprehensive Cancer Center/Jackson Memorial Hospital between January 1999 and June 2011.

The review identified 46 women and 1 man with breast cancer and HIV. The average patient age was 46 years (range 31-65 years), 79% were African-American, 21% were white, and 14% were Hispanic. Two-thirds of the women were pre-menopausal.

Results

o      Stage 0 -- tumor in situ, or non-invasive cancer: 4%;

o      Stage 1 -- cancer invading normal breast tissue or lymph nodes, with tumors smaller than 2 mm: 6%;

o      Stage 2 -- cancer that has spread to underarm lymph nodes, with tumors smaller than 5 mm: 38%;

o      Stage 3 -- cancer that forms clumps and may have spread further into the chest: 38%;

o      Stage 4 - invasive cancer that has spread to other organs: 9%.

Based on these findings, the researchers concluded, "Breast cancer in patients with HIV infection spans the spectrum of breast cancer presentations."

"Hormonal therapy, surgery, and radiation therapy were well tolerated," they continued. "Infectious complications were common in patients treated with chemotherapy and routine use of growth factors [for blood cell deficiencies] and prophylactic acyclovir [to prevent herpesvirus infections] should be considered."

6/5/12

Reference

REOchoa, C Kyriakopoulos, J Hurley, et al. Outcomes of 47 patients with human immunodeficiency virus infection treated for breast cancer: A 20-year experience. American Society of Clinical Oncology Annual Meeting (ASCO 2012). Chicago, June 1-5, 2012. Journal of Clinical Oncology 30 (supplement). Abstract 1071.