Breast cancer in a cohort of human immunodeficiency virus (HIV)-infected women from Rio de Janeiro, Brazil: a cases series report and an incidence rate estimate

Andrade, Angela Cristina Vasconcelos de; Luz, Paula M.; Veloso, Valdiléa G.; Cardoso, Sandra Wagner; Moreira, Ronaldo I.; Grinsztejn, Beatriz; Friedman, Ruth Khalili

doi:10.1590/s1413-86702011000400016

Cited by 12 publications

(26 citation statements)

References 26 publications

(45 reference statements)

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“…There are studies that support our finding of HIV-infected cancer patients being likely to have more advanced disease at diagnosis than similarly staged non-infected patients, and to have a poorer prognosis. [7,11,12,28] This could be due to the direct and indirect effects of the HIV virus on cancer biology. An indirect consequence of HIV infection is long-term immune suppression and alterations.…”

Section: Discussionmentioning

confidence: 99%

“…[30] Furthermore, HIV-infected women are less likely than those who are uninfected to undergo routine screening mammography, which may ultimately play a role in later diagnosis and more advanced presentation of breast cancer. [11,31] A high proportion of HIV-infected patients are young, and routine screening methods and education have largely targeted older women. Whether HIV infection alters the presentation or outcome of breast cancer is unknown, [9] as there have not yet been any large prospective cohort studies.…”

Section: Discussionmentioning

confidence: 99%

“…Whether HIV infection alters the presentation or outcome of breast cancer is unknown, [9] as there have not yet been any large prospective cohort studies. [8,11] Reduction of a patient's chemotherapy dose in response to neutropenia may lead to improvement of the neutropenia. However, like many other drugs, chemotherapeutic drugs have a dose-response relationship.…”

Section: Discussionmentioning

confidence: 99%

“…[9,10] The available evidence has also suggested that HIV-infected cancer patients in general have a worse prognosis than similarly staged non-infected patients with the same cancer, and that they are also likely to have more advanced disease at diagnosis. [11,12] Chemotherapy-induced neutropenia (CIN) is one of the most serious haematological toxicities caused by chemotherapy. [13] Its prevalence in HIV-infected women with breast cancer is unknown.…”

Section: Researchmentioning

confidence: 99%

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Incidence of chemotherapy-induced neutropenia in HIV-infected and uninfected patients with breast cancer receiving neoadjuvant chemotherapy

et al. 2017

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Background. Chemotherapy-induced neutropenia (CIN) can result in poor tolerance of chemotherapy, leading to dose reductions, delays in therapy schedules, morbidity and mortality. Actively identifying predisposing risk factors before treatment is of paramount importance. We hypothesised that chemotherapy is associated with a greater increase in CIN and its complications in HIV-infected patients than in those who are not infected. Objective. To establish the incidence of CIN in HIV-infected and uninfected patients undergoing chemotherapy. Methods. A retrospective chart review and analysis was conducted in the oncology departments at Inkosi Albert Luthuli Central Hospital and Addington Hospital, Durban, South Africa. The study population consisted of 65 previously untreated women of all ages with stage II -IV breast cancer and known HIV status treated with neoadjuvant chemotherapy from January 2012 to December 2015. Results. HIV-infected patients formed 32.3% of the group, and 95.2% of them were on antiretroviral therapy. The mean age (standard deviation (SD)) of the cohort was 48.5 (13.2) years (40.6 (9.6) years for the HIV-infected group v. 52.0 (13.1) years for the uninfected group; p<0.001). Ninety-five neutropenia episodes were observed (rate 0.85 per 1 year of follow-up time). Following multivariate adjustment, patients with HIV infection were almost two times more likely to develop CIN (hazard ratio (HR) 1.76, 95% confidence interval (CI) 1.06 -2.92; p=0.029. A high baseline absolute neutrophil count (ANC) (HR 0.80, p=0.005) remained significantly associated with protection against CIN. Conclusions. HIV-infected patients were younger than those who were not infected, and presented at a more locally advanced stage of disease. HIV infection was an independent predictor for CIN. HIV-infected patients had an almost two-fold increased risk of developing CIN and developed neutropenia at a much faster rate. A high baseline white cell count and ANC were protective against CIN.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Researchmentioning

confidence: 99%

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Incidence of chemotherapy-induced neutropenia in HIV-infected and uninfected patients with breast cancer receiving neoadjuvant chemotherapy

et al. 2017

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“…Moreover, immunodeficiency in the presence of other risk factors is responsible for the increased risk of NADM, which since 2003 exceeds the annual numbers of AIDS defining cancers in US 7 . However, there have been few reports of cancer and HIV in Brazil 13,14,15,16 . Thus, the aim of this study was to report the prevalence of cancer and its associated factors among HIV-infected individuals attending an AIDS outpatient clinic in Vitória, State of Espírito Santo, Brazil.…”

Section: Introductionmentioning

confidence: 99%

Malignancies in HIV/AIDS patients attending an outpatient clinic in Vitória, State of Espírito Santo, Brazil

Neto

Milanez

Golub

et al. 2012

Rev. Soc. Bras. Med. Trop.

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Introduction: The present study investigated cancer prevalence and associated factors among HIV-infected individuals attending an AIDS outpatient clinic in Vitória, State of Espírito Santo, Brazil. Methods: A sectional study was conducted among HIV infected adults attending an AIDS outpatient clinic in Vitória, State of Espírito Santo, Brazil. Demographic, epidemiological and clinical data were abstracted from medical records, including cancer diagnoses; nadir and current CD4 cell count, HIV viral load, time on antiretroviral treatment (ART), type of ART and smoking status. Results: A total of 730 (91.3%) patients were included in the study. Median age was 44.0 [interquartile range (IQR): 35–50.3] years; median time since HIV diagnosis was 5.5 years (IQR: 2–10); 60% were male; and 59% were white. Thirty (4.1%) cases of cancer were identified of which 16 (53%) were AIDS defining cancers and 14 (47%) were non-AIDS defining malignancies. Patients diagnosed with cancer presented higher chance of being tobacco users [OR 2.2 (95% CI: 1.04–6.24)]; having nadir CD4 ≤200 cells/mm3 [OR 3.0 (95% CI: 1.19–7.81)] and higher lethality [OR 13,3 (95% CI: 4,57–38,72)]. Conclusions: These results corroborate the importance of screening for and prevention of non-AIDS defining cancers focus in HIV-infected population, as these cancers presented with similar frequency as AIDS defining cancers.

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Clinical outcomes in breast cancer patients with HIV/AIDS: a retrospective study

Gomez

Montero

Hurley

2015

Breast Cancer Res Treat

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The purpose of the study is to describe what is the presentation of breast cancer in women with HIV, their tolerance to therapy, the most common complications of treatment and their outcomes. Retrospective chart review of patients with HIV diagnosed with breast cancer between January 1, 1989 and December 31, 2013 at the University of Miami/Jackson Memorial Hospital (UM/JMH) 47 females and 1 male were included in the analysis. The median age of diagnosis was 46 years (IQR 41-52) and 64% of the women were premenopausal. Median CD4(+) count was 330 cells/µL (IQR 131-589 cells/µL). 41% had AIDS at time of diagnosis. 94% of patients presented with locoregional disease and 6% with late stage breast cancer. 52% had ER(+) tumors. 6% had HER-2/neu tumor expression and 21 % had triple negative disease. The 5 year PFS was 50% (95% CI 34-64%), the 5 year OS was 44% (95% CI 29-58%), and the Breast cancer-specific survival was 57% (95% CI 40-70%). Death was attributed to breast cancer in 22 patients, AIDS progression in 6 patients, other medical condition in 1, and for 4, the cause was unknown. Serious adverse events were documented in 46% of patients treated with chemotherapy. Targeted therapy was well tolerated. Patients with HIV/AIDS and breast cancer pose a major challenge for oncologists. Surgery, radiation, and endocrine therapy are well tolerated. Standard dose chemotherapy can have life-threatening side effects which can be managed with growth factor support and antimicrobial prophylaxis. All cancer therapy can be given while continuing with antiviral therapy at full dose.

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Breast cancer in a cohort of human immunodeficiency virus (HIV)-infected women from Rio de Janeiro, Brazil: a cases series report and an incidence rate estimate

Cited by 12 publications

References 26 publications

Incidence of chemotherapy-induced neutropenia in HIV-infected and uninfected patients with breast cancer receiving neoadjuvant chemotherapy

Incidence of chemotherapy-induced neutropenia in HIV-infected and uninfected patients with breast cancer receiving neoadjuvant chemotherapy

Malignancies in HIV/AIDS patients attending an outpatient clinic in Vitória, State of Espírito Santo, Brazil

Clinical outcomes in breast cancer patients with HIV/AIDS: a retrospective study

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