Biomaterial Database

South African Breast Cancer and HIV Outcomes Study: Methods and Baseline Assessment. 2017

Herbert Cubasch, and Paul Ruff, and Maureen Joffe, and Shane Norris, and Tobias Chirwa, and Sarah Nietz, and Vinay Sharma, and Raquel Duarte, and Ines Buccimazza, and Sharon Čačala, and Laura W Stopforth, and Wei-Yann Tsai, and Eliezer Stavsky, and Katherine D Crew, and Judith S Jacobson, and Alfred I Neugut

Herbert Cubasch, Sarah Nietz, Paul Ruff, Maureen Joffe, Shane Norris, Tobias Chirwa, Vinay Sharma, and Raquel Duarte, University of the Witwatersrand; Sarah Nietz, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg; Herbert Cubasch and Vinay Sharma, Chris Hani Baragwanath Academic Hospital, Soweto; Ines Buccimazza, University of KwaZulu-Natal; Ines Buccimazza, Inkosi Albert Luthuli Central Hospital, Durban; Sharon Čačala and Laura W. Stopforth, Grey's Hospital, Pietermaritzburg, South Africa; and Wei-Yann Tsai, Eliezer Stavsky, Katherine D. Crew, Judith S. Jacobson, and Alfred I. Neugut, Columbia University, New York, NY.

OBJECTIVE In low- and middle-income, HIV-endemic regions of sub-Saharan Africa, morbidity and mortality from the common epithelial cancers of the developed world are rising. Even among HIV-infected individuals, access to antiretroviral therapy has enhanced life expectancy, shifting the distribution of cancer diagnoses toward non-AIDS-defining malignancies, including breast cancer. Building on our prior research, we recently initiated the South African Breast Cancer and HIV Outcomes study. METHODS We will recruit a cohort of 3,000 women newly diagnosed with breast cancer at hospitals in high (average, 20%) HIV prevalence areas, in Johannesburg, Durban, Pietermaritzburg, and Empangeni. At baseline, we will collect information on demographic, behavioral, clinical, and other factors related to access to health care. Every 3 months in year 1 and every 6 months thereafter, we will collect interview and chart data on treatment, symptoms, cancer progression, comorbidities, and other factors. We will compare survival rates of HIV-infected and uninfected women with newly diagnosed breast cancer and their likelihood of receiving suboptimal anticancer therapy. We will identify determinants of suboptimal therapy and context-specific modifiable factors that future interventions can target to improve outcomes. We will explore molecular mechanisms underlying potentially aggressive breast cancer in both HIV-infected and uninfected patients, as well as the roles of pathogens, states of immune activation, and inflammation in disease progression. CONCLUSIONS Our goals are to contribute to development of evidence-based guidelines for the management of breast cancer in HIV-positive women and to improve outcomes for all patients with breast cancer in resource-constrained settings.