Commentary on “Breast Cancer and Human Immunodeficiency Virus: A Report of 20 Cases”

rate of male breast cancer was noted. More recently Cooksley et al have merged data from independently maintained cancer and HIV registries in Texas, again failing to demonstrate an increase in breast cancer in the setting of HIV.2 So, what can we conclude about the behavior of breast cancer in the HIVinfected host? Until now, the only information available was from scattered case reports available in the literature.6 Hurley et al have provided a careful analysis of 20 patients in a single institution, doubling the previously reported experience.7 More importantly, they have provided previously unavailable information on demographics, stage, and response to treatment. Their patients were older, with an average age of 44. While three fourths of the previously described patients had stage 4 disease, the majority of women treated by Hurley et al were stages 0-2. Their experience with adjuvant therapy is of particular interest; while there was a high morbidity and mortality rate with standard-dose chemotherapy, patients did much better with tamoxifen, even those with extensive regional disease.