Patient description: The patient is a 45-year-old postmenopausal woman with cytologically confirmed breast cancer. A core biopsy revealed a 3 cm invasive ductal breast carcinoma in the left upper outer quadrant. The tumor is HER2-positive and ER/PR negative. Axillary sampling revealed 5 positive lymph nodes. CXR was remarkable for metastatic lesions. The patient is using multivitamins and iron supplements. She does not smoke or consume alcohol. She is not sexually active and has no children. She is a candidate for tumor resection and agrees to do so prior to chemotherapy.

Clinical trial eligibility criteria: eligible ages (years): 18.0-100.0,  Breast Cancer Menstrual Cycle Study: To participate in the Menstrual Cycle Pilot Study, a woman must: 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 46 years of age. Must be premenopausal as determined by menstrual history (no change in menstrual pattern in prior 6 months) and an FSH level less than 15 mIU/ml obtained on the third day of the menstrual cycle. Have undergone genetic counseling and risk assessment. Must be a known mutation carrier or be 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. 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. Be willing to use non-hormonal methods of contraception until completion of the 3 month follow-up studies. Have an ECOG performance status of 0-1. Be able to provide informed consent  Menstrual Cycle Study: Any of the following will result in from the Menstrual Cycle Pilot Study: A history of menstrual cycle irregularities over the previous 6 months, including history of cycles less than 26 days or more than 35 days. Steroid therapy, use of selective estrogen receptor modulators (SERMs) or hormonal agents (including tamoxifen, raloxifene, estrogen, DHEA, anabolic steroids, oral contraceptives, depoprovera, progestin IUD, oral progestins, norplant, or drugs to induce ovulation) within 6 months prior to study entry and must agree not to use these compounds until completion of the three-month follow-up study. Pregnancy or lactation within 12 months of enrollment. History of infertility with a suspected ovarian etiology or persistent ovarian cyst. Abnormal CA-125 level. History of invasive cancer except for non-melanoma skin cancer or cervical carcinoma in situ. Creatinine greater than 2. Previous bilateral mastectomy, bilateral radiation therapy to the breast, or oophorectomy. History of DCIS or LCIS . Weight over 136 kilograms. Allergy to gadolinium. Allergy to lidocaine or Marcaine (bupivacaine) (excluded from breast duct 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 Training Cohort: To participate in the Training Cohort a volunteer must Be female and at least 18 years and less than 51 years of age Have at least one breast considered eligible for study Provide evidence (either films or radiologist's report) of a mammogram done within the 12 months prior to enrollment showing low or no suspicion of carcinoma in at least one breast. (Mammograms will not be provided to participants as part of the training cohort.) Have a physical examination of the breast to be studied consistent with low or no suspicion of carcinoma at the time of enrollment Provide the name of a primary care physician to whom the results of breast duct lavage cytologies can be sent Have signed the informed consent for breast duct lavage Training Cohort: Any of the following will a potential participant from the Training Cohort Pregnancy or lactation within the past 12 prior to enrollment