Mariana Brandão1,2,3, Marco Bruzzone4, Maria-Alice Franzoi1, Claudia De Angelis1, Daniel Eiger1, Rafael Caparica1, Martine Piccart-Gebhart1, Laurence Buisseret1, Marcello Ceppi4, Nicolas Dauby5,6,7, Carla Carrilho8,9, Nuno Lunet2,3, Evandro de Azambuja1, Matteo Lambertini4,10. 1. Institut Jules Bordet, Université Libre de Bruxelles (ULB), Boulevard de Waterloo, Bruxelles, Belgium. 2. EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas. 3. Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, Porto, Portugal. 4. IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, Genova, Italy. 5. Infectious Diseases Department, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), Rue Haute, Bruxelles, Belgium. 6. Institute for Medical Immunology, Université Libre de Bruxelles (ULB), Rue Adrienne Bolland, Gosselies. 7. Centre for Environmental Health and Occupational Health, School of Public Health, Université Libre de Bruxelles (ULB), Bruxelles, Belgium. 8. Pathology Department, Faculty of Medicine, University Eduardo Mondlane, Avenida Salvador Allende. 9. Department of Pathology, Maputo Central Hospital, Avenida Eduardo Mondlane, Maputo, Mozambique. 10. University of Genova, Genova, Italy.
Abstract
BACKGROUND: As women living with HIV (WLWH) become older, their risk of developing breast cancer increases. Nonetheless, literature is conflicting regarding tumor stage, distribution of subtypes and overall survival among WLWH vs. HIV-negative women with breast cancer. We assessed differences in clinicopathological characteristics and overall survival between these two groups. METHODS: Systematic review and meta-analysis using MEDLINE, Scopus, ISI Web of Knowledge, LILACS, SciELO and conference abstracts up to 1 January 2020. Cross-sectional/cohort studies comparing baseline characteristics (stage and/or subtypes) and/or overall survival of WLWH vs. HIV-negative women with breast cancer were included. We performed random-effects meta-analyses to estimate summary statistics and subgroup analyses according to region of the world. RESULTS: Eighteen studies [4 from North America, 14 from sub-Saharan Africa (SSA)] were included, with 3174 WLWH and 2 394 598 HIV-negative women. WLWH from North America and SSA were more likely to present with stage III/IV disease compared with HIV-negative women - pooled odds ratio (pOR) 1.76 [95% confidence interval (CI):1.58-1.95] and pOR 1.23 (95% CI: 1.06-1.42), respectively. WLWH from SSA were also less likely to have estrogen receptor-positive/HER2-negative tumors (pOR 0.81; 95% CI: 0.66-0.99). After adjustment, WLWH had worse overall survival compared with HIV-negative women, both in North America [pooled adjusted hazard ratio (aHR) 2.45; 95% CI: 1.11-5.41] and SSA (aHR 1.43; 95% CI: 1.06-1.92). CONCLUSION: Compared with HIV-negative women, WLWH are diagnosed with breast cancer at a more advanced stage and have a worse overall survival. These results should raise awareness regarding the detection and survival gap among WLWH with breast cancer and further studies are needed to decipher the reasons behind these disparities.
BACKGROUND: As women living with HIV (WLWH) become older, their risk of developing breast cancer increases. Nonetheless, literature is conflicting regarding tumor stage, distribution of subtypes and overall survival among WLWH vs. HIV-negative women with breast cancer. We assessed differences in clinicopathological characteristics and overall survival between these two groups. METHODS: Systematic review and meta-analysis using MEDLINE, Scopus, ISI Web of Knowledge, LILACS, SciELO and conference abstracts up to 1 January 2020. Cross-sectional/cohort studies comparing baseline characteristics (stage and/or subtypes) and/or overall survival of WLWH vs. HIV-negative women with breast cancer were included. We performed random-effects meta-analyses to estimate summary statistics and subgroup analyses according to region of the world. RESULTS: Eighteen studies [4 from North America, 14 from sub-Saharan Africa (SSA)] were included, with 3174 WLWH and 2 394 598 HIV-negative women. WLWH from North America and SSA were more likely to present with stage III/IV disease compared with HIV-negative women - pooled odds ratio (pOR) 1.76 [95% confidence interval (CI):1.58-1.95] and pOR 1.23 (95% CI: 1.06-1.42), respectively. WLWH from SSA were also less likely to have estrogen receptor-positive/HER2-negative tumors (pOR 0.81; 95% CI: 0.66-0.99). After adjustment, WLWH had worse overall survival compared with HIV-negative women, both in North America [pooled adjusted hazard ratio (aHR) 2.45; 95% CI: 1.11-5.41] and SSA (aHR 1.43; 95% CI: 1.06-1.92). CONCLUSION: Compared with HIV-negative women, WLWH are diagnosed with breast cancer at a more advanced stage and have a worse overall survival. These results should raise awareness regarding the detection and survival gap among WLWH with breast cancer and further studies are needed to decipher the reasons behind these disparities.
Authors: Oluwatosin A Ayeni; Daniel S O'Neil; Yoanna S Pumpalova; Wenlong Carl Chen; Sarah Nietz; Boitumelo Phakathi; Ines Buccimazza; Sharon Čačala; Laura W Stopforth; Hayley A Farrow; Witness Mapanga; Maureen Joffe; Tobias Chirwa; Valerie McCormack; Judith S Jacobson; Katherine D Crew; Alfred I Neugut; Paul Ruff; Herbert Cubasch Journal: Int J Cancer Date: 2022-03-04 Impact factor: 7.316