Patient description: The patient is a 42 year-old postmenopausal woman who had a screening sonogram which revealed an abnormality in the right breast. She had no palpable masses on breast exam. Core biopsy was done and revealed a 1.8 cm infiltrating ductal breast carcinoma in the left upper outer quadrant. Lumpectomy was done and the surgical margins were clear. The tumor was HER2-positive and ER/PR negative. Axillary sampling revealed 1 positive lymph node out of 12 sampled. CXR was unremarkable. She is using “well women” multivitamins daily and no other medication. She smokes frequently and consumes alcohol occasionally. She is in a relation with only one partner and has a history of 3 pregnancies and live births. She breastfed all three children.

Clinical trial eligibility criteria: eligible ages (years): 18.0-100.0,  Breast Cancer Annual Follow-up Study: To participate in the Annual Follow-up Study, a woman must: Be at least 25 years of age (or 5 years younger than the age at diagnosis of the youngest family member with a tumor associated with the Breast-Ovarian Cancer Syndrome) and less than 56 years of age. Must be: A known BRCA1 or BRCA2 deleterious mutation carrier OR A first or second degree relative of an individual known to carry a deleterious BRCA1 or BRCA2 mutation OR A first or second degree relative of an individual with a tumor associated with the Breast-Ovarian Cancer Syndrome in a family with a known BRCA mutation. Have undergone genetic counseling and risk assessment. Agree to release of genetic test result for stratification purposes, whether or not she has chosen to receive individual test results for clinical decision-making. Have an ECOG performance status of 0-1. Be able to provide informed consent. Have at least one non-irradiated breast  Annual Follow-up Study: Any of the following will result in from the Annual Follow-up Study: Pregnancy or lactation within 6 months of enrollment. Abnormal CA-125 level. Bilateral breast cancer, ovarian (any stage) or breast cancer (Stage IIB or worse) unless relapse free for 5 years prior to the time of enrollment. Patients with DCIS, Stage I and Stage II breast cancer are eligible provided that it has been at least 6 months from the completion of primary therapy (surgery, radiation, and chemotherapy as applicable). Tamoxifen and aromatase inhibitor adjuvant therapy is allowed. Patients with DCIS, Stage I and Stage II breast cancer who have had a local relapse after primary treatment are not eligible unless they have been relapse free for 5 years prior to the time of enrollment. History of other invasive cancer unless relapse free for 5 years prior to the time of enrollment. Non-Melanoma skin cancer or cervical carcinoma in situ are excepted. Previous bilateral mastectomy or bilateral radiation therapy. Weigh over 136 kilograms. Allergy to gadolinium. Allergy to lidocaine or Marcaine (bupivacaine). (excluded from breast duct lavage only). Subareolar or other surgery of the breast to be studied which might disrupt the ductal systems. For example, papilloma resection, biopsy or fine needle aspirations (FNAs) within 2 cm of the nipple might disrupt the ductal systems. Biopsies or FNAs greater than 2 cm from the nipple are acceptable. (Excluded from ductal lavage only) A breast implant or prior silicone injections in the breast to be studied. (Exclude from breast ductal lavage only) Active infections or inflammation in a breast to be studied. (breast ductal lavage only) Medical or psychiatric disorder which, in the opinion of the Principal Investigator, would preclude informed consent or ability to participate in clinical research