Only 16 cases of breast carcinoma in human immunodeficiency virus (HIV) seropositive patients have been reported in the literature. We report four cases of breast cancer in women seropositive for the HIV and review the literature. Breast cancer is not an acquired immunodeficiency syndrome (AIDS)-defining disease and its incidence is not increased in HIV patients. Most patients reported had a CD4 count, which was above the threshold considered critical for significant immunosuppression suggesting that, HIV related immunocompromise does not have a direct tumorigenic role. Alternatively, the biology of breast cancer appears to be more aggressive in HIV-positive women suggesting a permissive role of the virus in the progression of the cancer. The aggressiveness of the breast carcinoma in HIV-positive women justifies every effort to preserve the dose intensity of treatment in those patients, especially in the current era of more effective HIV treatment which leads to improved survival.