• Treatment effects and correlation of changes in morphometrics and biomarkers as assessed by mammogram and magnetic resonance image (MRI) densities on days 1 and 300 [ Designated as safety issue: No ]
  
• Perspectives about risk reduction options and their impact on quality of life (QOL) as assessed by Medical Outcomes 36-item short-form version, Health Perceptions scale, and Body Image scale on days 1, 169, and 300, and then every 6 months for 2 years [ Designated as safety issue: No ]
  

OBJECTIVES:

• Determine the effects of deslorelin in combination with low-dose add-back estradiol and testosterone on the breast of premenopausal women with or without a BRCA gene mutation who are at high risk for breast cancer.
• Correlate changes in mammographic and MRI densities with tissue morphometrics and biomarkers in participants treated with this regimen.
• Determine cell proliferation and changes in estrogen receptor, progesterone receptor, or aromatase expression in participants treated with this regimen.
• Determine perspectives about risk reduction options in participants treated with this regimen.
• Determine the impact of this regimen on the quality of life of these participants.
• Analyze the expression of BRCA1 and BRCA2 in breast tissue of these participants before and after treatment with this regimen.

OUTLINE: This is a pilot study.

Participants receive intranasal deslorelin, estradiol, and testosterone once daily for 6-10 months.

Quality of life is assessed at baseline, at 6 and 10 months, and then every 6 months until 2 years after study registration.

PROJECTED ACCRUAL: A total of 10 participants will be accrued for this study.

DISEASE CHARACTERISTICS:

• Known high risk of breast cancer due to a BRCA gene mutation OR empiric risk > 30% lifetime by the Claus model
• No immeasurable breast density on mammogram (BIRADS 1)

• Meets criteria for 1 of the following:

  • Planning a risk-reduction mastectomy in 6 months or more
  • Planning to continue surveillance

• Hormone receptor status:

  • Not applicable

PATIENT CHARACTERISTICS:

Age

• 21 to 48

Sex

• Female

Menopausal status

• Premenopausal

Performance status

• Not specified

Life expectancy

• Not specified

Hematopoietic

• Hematopoietic function within normal limits

Hepatic

• Hepatic function within normal limits

Renal

• Renal function within normal limits

Other

• In generally good health with normal laboratory values and physical examination

• Not pregnant or nursing

  • No pregnancy or nursing within the past 6 months
• Negative pregnancy test
• Fertile patients must use effective nonhormonal barrier contraception
• Non-smoker
• No prior or suspected malignancy except nonmelanoma skin cancer
• No nasal polyposis
• No atrophic, severe allergic, or vasomotor rhinitis
• No sinusitis requiring current treatment or treatment for more than 3 months in the past year

PRIOR CONCURRENT THERAPY:

Biologic therapy

• Not specified

Chemotherapy

• Not specified

Endocrine therapy

• More than 1 year since prior gonadotropin-releasing hormone agonist therapy
• At least 6 months since prior implanted or injected contraceptives
• No concurrent corticosteroids
• No other concurrent estrogens, progestins, or androgens, including oral, implanted, or injected contraceptives

Radiotherapy

• Not specified

Surgery

• See Disease Characteristics