Dedicated to the care of breast cancer and all breast conditions
Dr Sarah Rayne is no longer practising in
Johannesburg and this practice is closed.

These pages are for information only,
and current only until 2018
HIV and the breast  
Over 20% of women of reproductive age in South Africa are HIV positive. More and more women are living life on treatment for HIV. Some problems of the breast can be more common in women who are HIV positive, and the treatment of other problems can be affect by your status. It is really important for every women to know her status, just like it is important to be breast aware: because picking up problems early means they are more easily treated.

Some ways HIV can affect the breast:

Breast enlargement in men and women
Breast skin problems
Breast infections
Breast lumps
Gynaecomastia and lipodystrophy syndromes
Breast enlargement in men (gynaecomastia) can affect men with HIV, and also affects med on anti-retrovirals (especially Efavirenz). Women can develop breast enlargement of one breast or of both. This can be related to a change in distribution of the fat of the body in other areas too- such as the tummy, a hump on the back, and loss of fat on the arms and legs. After investigation and confirmation of the cause, a change in treatment may help.

Gynaecomastia can be seen in males patients infected with HIV and in those on HAART. Efavirenz
Breast skin problems
Shingles is common, not just in HIV positive people, and causes severe acute pain around the breast (commonly one side). The classic rash that comes with shingles may develop later.
Breast infections
All breast lumps should be examined and investigated. Some infections causing abscesses or hard lumps can occur and if an infection does not respond to antibiotics, less common causes like Tuberculosis (TB) should be looked for. Cancer should always be ruled out. Although treatment for infection may take a long time, these problems can all be treated and there is not a reason to operate on or remove the breast.
Breast lumps
Some lumps in the breast may be lymph nodes reacting to infection. They are typically in the tail of the breast extending towards the armpit. These lymph nodes can also swell due to cancer of the breast, or cancer in the lymph glands itself (lymphoma) which can occur in HIV positive women. Every lump in the breast should be examined and investigated.

Breast cancer can occur in any woman. HIV does not mean that you are at higher risk, but you should still get every lump or problem checked out. HIV positive women can still have the same treatments for cancer as HIV negative women safely and with no worry that it will make either the cancer or the HIV worse.