• Effect of menstrual cycle phase on breast imaging outcome measures in BRCA1 or BRCA2 mutation carriers and non carriers as measured by mammographic density (qualitative and quantitative), semiquantitative measure of fibroglandular volume, and of dyna ... [ Designated as safety issue: No ]
  

• Imaging of normal breast tissue in BRCA1 and BRCA2 mutation carriers and non-carriers prior to breast biopsy [ Designated as safety issue: No ]
  
• Imaging characteristics of normal breast tissue in BRCA 1 and BRCA2 mutation carriers and non-carriers prior to breast biopsy [ Designated as safety issue: No ]
  
• Breast ductal lavage to obtain epithelial cells for cytologic evaluation and molecular studies in premenopausal women as measured by cytology reports annually [ Designated as safety issue: No ]
  
• Correlate breast duct lavage cytologies from asymptomatic premenopausal mutation carriers and non-carriers with menstrual cycle timing as measured by cytology reports annually [ Designated as safety issue: No ]
  
• Psychosocial impact of study participation in an intensive breast cancer screening program as measured by center for epidemiologic studies depression scale (CESD), BSl-18, telephone interview, and self-administered questionnaire at baseline and annua ... [ Designated as safety issue: No ]
  
• Prior breast screening practices as measured by telephone interview and self-administered questionnaire at baseline [ Designated as safety issue: No ]
  
• Tolerability of study treatment as measured by Day 1 Day 2 questionnaire at first screening visit [ Designated as safety issue: Yes ]
  
• Family communication patterns as measured by CEGRAM annually [ Designated as safety issue: No ]
  

OBJECTIVES:

• Determine the effect of menstrual cycle on five breast imaging methods and any differences in these imaging results between women who are BRCA1 or BRCA2 mutation carriers and non-carriers.
• Assess the use of breast duct lavage to obtain epithelial cell samples for cytologic evaluation and molecular/genetic studies in women with BRCA1 or BRCA2 mutations.
• Compare breast duct lavage cytologies from asymptomatic premenopausal BRCA1 or BRCA2 mutation carriers and non-carriers to assess whether the results vary with menstrual cycle timing.

OUTLINE:

Menstrual cycle study:

• Participants undergo a physical exam, including the breast and pelvis, standard four-view mammogram, and breast magnetic resonance imaging scan during either the early follicular phase or the mid-luteal phase of the menstrual cycle. Participants also undergo a CA 125 level determination and transvaginal color doppler ultrasonography. Three months later, participants undergo a unilateral cranio-caudal mammogram and bilateral MRI during the menstrual cycle phase not previously studied. All participants undergo breast duct lavage at each study visit. Repeat screening studies are performed annually for 3 years.
• Participants are followed annually.

Training cohort study (to train investigators to perform breast duct lavage):

• Volunteers undergo cancer risk assessment and nipple aspiration. Breast duct lavage may be performed on participants who express nipple aspiration fluid. Results are sent to the participant and her physician. Participants with atypical cytologies are contacted individually, and an appropriate follow-up plan is made in coordination with her physician.

PROJECTED ACCRUAL: Approximately 50 participants (25 BRCA1 or BRCA2 mutation carriers and 25 BRCA1 or BRCA2 mutation non-carriers) will be accrued for the menstrual cycle study, and 25 participants will be accrued for the training cohort study.