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Breast Cancer and HIV: State of the Art and Practical Implications

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Abstract

Breast cancer is most common in women, and its incidence in HIV population, after the introduction of antiretroviral therapy, has increased to a level approaching that of the general population. This review will be focused on breast cancer in HIV-positive patients with particular reference to epidemiology, screening strategies, clinico-pathological features, and treatment, including the interaction between chemotherapy and HAART. Recent cohort studies on HIV-positive women have clearly shown a shift towards increasing breast cancer incidence, with levels now approaching those in the HIV-negative population. Screening disparities exist yet between HIV-positive and HIV-negative women emphasizing the importance of biennial mammography to detect early breast cancer in women aged 50–74 years, who live with HIV/AIDS. Cancer stage, cancer pathology characteristics, and survival outcome are similar in HIV-positive and HIV-negative patients, although the fear of additional complications and toxicity often leads to HIV-positive patients receiving sub-optimal treatment. The best management of breast cancer in HIV patients consists in a multidisciplinary approach between oncologists and infectious disease specialists to guarantee the patients the correct diagnostic work-up and the most appropriate therapeutic approach aiming to reduce drug-drug interactions and overlapping toxicities of both treatments.

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  1. Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale C. Golgi 19, 27100, Pavia, Italy

    Angioletta Lasagna, Elisa Ferraris, Giovanna Armani, Gianpiero Rizzo, Richard J. Tancredi & Paolo Pedrazzoli

  2. Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Valentina Zuccaro, Paolo Sacchi & Layla Pagnucco

  3. Dept. of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy

    Paolo Pedrazzoli

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A. L. conceived and formulated the article. A. L. and V. Z. performed the literature search and data analysis. A. L. wrote the first draft of the manuscript and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Lasagna, A., Zuccaro, V., Sacchi, P. et al. Breast Cancer and HIV: State of the Art and Practical Implications. SN Compr. Clin. Med. 3, 1727–1739 (2021). https://doi.org/10.1007/s42399-021-00950-z

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