Abstract P2-07-07: Comparison of survival and clinicopathological features between patients with breast cancer and HIV infection versus breast cancer without HIV infection
Authors: Gligich O , Acuna A , Khan H , Kim R , Wang D , Sparano J , Anampa J 
Published: March 2017

Background:

Breast cancer (BCA) is the most common malignancy and the most common cause of death among females worldwide. The use of antiretroviral therapy prolonged life expectancy and increased the incidence of age-related malignancies in patients with the human immunodeficiency virus (HIV). Data regarding the protective versus deleterious effect of HIV in the presentation, clinical course and mortality of patients with BCA is limited.

Objective: To compare the median overall survival between patients with and without HIV diagnosed with breast cancer between 2000 and 2014 at Montefiore Medical Center.

Methods: Patients with HIV infection and breast cancer diagnosed between 2000 and 2014 were identified. Controls were randomly selected from a pool of 5552 patients with BCA without HIV using stratified sampling by year of breast cancer diagnosis with a ratio of 3 controls per case. Patients were followed up for a median of 52 months. Median overall survival and clinicopathological characteristics were compared among groups.

Results: A total of 42 cases of BCS with HIV infection were identified. Of 126 selected controls; 15 were excluded after chart review. Patients with HIV were diagnosed with breast cancer at significantly younger ages compared to non-HIV patient (50.6 vs 64.8, P &lt;.001), had lower BMI (26 vs 30.1, p&lt;0.001) and had higher frequency of Not-hispanic Black (NHB) (64.3% vs 41.4%). Breast cancer stage, grade, histological type and hormonal status as well as surgery, chemotherapy and hormonal therapy were not significantly different between the groups; but the HIV group had a tendency towards less hormonal therapy. There was no difference in the rate of mortality; however overall median survival was higher in patient with HIV. This difference was not statistically significant (106 vs 72, p=0.78)

Conclusion: Patients with HIV are diagnosed with breast cancer at younger ages than the general population. Closer monitoring in this population was suggested by other authors; however the rate of stage I disease is similar between both groups. Despite similar rates of surgery and chemotherapy, higher rates of NHB and less hormonal therapy, mortality rates were similar in both groups and median overall survival was higher in patient with HIV.

 Breast cancer with HIV (n = 42)Breast cancer without HIV (n = 111)p-value*Age at BCA diagnosis50.6 (11.2)64.8 (14.4)&lt; 0.001BMI26.0 (6.2)30.1 (7.4)&lt; 0.001Race, n (%)  0.014White, Not-Hispanic3 (7.1)23 (20.7) Black, Not-Hispanic27 (64.3)46 (41.4) Hispanic9 (21.4)28 (25.2) Other/unknown3 (7.1)14 (12.6) Post menopausal, yes (%)16 (40)84 (80.7)&lt; 0.001Breast cancer stage, n (%)  0.15115 (37.5)39 (39.00) 215 (37.5)43 (43.00) 38 (20)18 (18.00) 42 (5.00)0 (0.00) Breast cancer grade, poor (%)17 (44.7)42 (42.4)0.94Histological type, n (%)  0.10IDC39 (92.86)89 (80.18) ILC2 (4.76)6 (5.41) Mixed1 (2.38)16 (14.41) Estrogen receptor, pos (%)25 (65.8)69 (72.6)0.43Progesterone receptor, pos (%)20 (52.6)52 (55.9)0.73Her 2 status, pos (%)11 (29)15 (16.5)0.11Chemotherapy, n (%)  0.4516 (15.38)13 (14.29) 222 (56.41)39 (42.86) 31 (2.56)3 (3.30) 410 (25.64)36 (39.56) Hormonal therapy, yes (%)21 (53.9)54 (70.1)0.08Dead, n (%)20 (48)57 (51)0.68Recurrence, n (%)9 (21)27 (24)0.71Median overall-survival in mo106720.78**

Citation Format: Gligich O, Acuna A, Khan H, Kim R, Wang D, Sparano J, Anampa J. Comparison of survival and clinicopathological features between patients with breast cancer and HIV infection versus breast cancer without HIV infection [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-07-07.