Breast Cancer
Conditions
Keywords
breast cancer, ductal breast carcinoma in situ, lobular breast carcinoma in situ, breast cancer in situ
Brief summary
RATIONALE: Chemoprevention is the use of certain drugs to keep cancer from forming, growing, or coming back. The use of sulindac may prevent breast cancer. PURPOSE: This randomized phase I trial is studying the effects of sulindac, to prevent breast cancer, in women at high risk for breast cancer.
Detailed description
OBJECTIVES: Primary * Determine the partitioning of sulindac and its metabolites in women at high risk for breast cancer by measuring drug and metabolite levels in nipple aspirate fluid (NAF) after 6 weeks of therapy. Secondary * Determine prostaglandin levels in the NAF of patients treated with this drug. * Determine if NAG-1 levels are induced in the NAF of patients treated with this drug. * Determine if C-reactive protein levels are reduced in the NAF of patients treated with this drug. * Determine if NAG-1 levels and/or karyometric features in ductal epithelial cells are modulated in patients treated with this drug. OUTLINE: This is a randomized, open-label study. Patients undergo nipple aspirate fluid (NAF) collection. Patients are then randomized to 1 of 2 treatment arms. * Arm I: Patients receive oral sulindac once daily. * Arm II: Patients receive oral sulindac twice daily. In both arms, treatment continues for 6 weeks in the absence of disease progression or unacceptable toxicity. All patients then undergo a second NAF collection. After completion of study treatment, patients are followed at 2 weeks. PROJECTED ACCRUAL: A total of 30 patients (15 per treatment arm) will be accrued for this study.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
DISEASE CHARACTERISTICS: * Meets 1 of the following criteria: * Gail assessment score \> 1.7% risk for 5 years * History of lobular carcinoma in situ (pathology report required) * History of ductal carcinoma in situ (DCIS) (pathology report required) * History of breast cancer in ≥ 1 first-degree relative or history of BRCA1 or BRCA2 positivity not treated with oophorectomy or mastectomy (test report required) * History of breast cancer in ≥ 2 second-degree relatives * Any family history of breast cancer diagnosed prior to age 50 * Personal history of breast cancer (invasive or DCIS) with 1 breast intact * Nipple aspirate fluid production ≥ 5 microliters * Negative mammogram for breast cancer within the past 10 months * Any suspicious breast masses must be examined by a clinical professional * Hormone receptor status: * Not specified PATIENT CHARACTERISTICS: Sex * Female Menopausal status * Pre- or postmenopausal Performance status * Karnofsky 80-100% Life expectancy * Not specified Hematopoietic * WBC ≥ 3,000/mm\^3 * Absolute neutrophil count ≥ 1,500/mm\^3 * Platelet count ≥ 100,000/mm\^3 * No history of bleeding or clotting disorder Hepatic * Bilirubin ≤ 2.0 mg/dL * AST and ALT ≤ 2.0 times upper limit of normal * No indication of abnormal liver function Renal * Creatinine normal Cardiovascular * No symptomatic congestive heart failure * No unstable angina pectoris * No cardiac arrhythmia Gastrointestinal * No frequent, chronic, or moderate/severe gastric complaint * No upper gastrointestinal problems (e.g., symptoms of heartburn, dyspepsia, or abdominal pain) requiring prescription or nonprescription medical remedies more than once per week (on average) * No history of peptic ulcer or occult or gross intestinal bleeding Other * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception * No history of allergic reaction (e.g., urticaria, asthma, rhinitis) or gastric intolerance attributed to compounds of similar chemical or biological composition to sulindac * No history of allergy attributed to lidocaine, EMLA® cream, or xylocaine * No concurrent uncontrolled illness * No ongoing or active infection * No psychiatric illness or social situation that would preclude study compliance * No more than 2-3 servings of alcohol per week during study participation PRIOR CONCURRENT THERAPY: Chemotherapy * More than 6 months since prior chemotherapy for breast cancer (invasive or DCIS) Endocrine therapy * More than 6 months since prior hormonal therapy for breast cancer (invasive or DCIS) * No concurrent hormone-suppressing agents (e.g., tamoxifen or anastrozole) * No concurrent selective estrogen-receptor modulators * No concurrent aromatase inhibitors Radiotherapy * More than 6 months since prior radiotherapy for breast cancer (invasive or DCIS) Surgery * See Disease Characteristics * No prior breast duct-disrupting surgery (e.g., mastectomy) that would preclude ductoscopy Other * More than 3 months since prior warfarin or other systemic anticoagulant * More than 4-6 weeks since prior nonsteroidal anti-inflammatory drugs * No concurrent phenytoin or sulfonamides * No concurrent warfarin or other systemic anticoagulant * No other concurrent nonsteroidal anti-inflammatory drugs (including low-dose aspirin) * No concurrent large doses of supplements, vitamins (\> regular daily multivitamin) and/or herbal medicines (e.g., echinacea, ginkgo biloba, Hypericum perforatum \[St. John's wort\], or herbal tea) * No other concurrent investigational agents
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Sulindac and sulindac metabolite levels in nipple aspirate fluid (NAF) after 6 weeks of treatment | — |
Secondary
| Measure | Time frame |
|---|---|
| Prostaglandin (PGE2) levels in NAF before and after 6 weeks of treatment | — |
| NAG-1 induction and C-reactive protein (CRP) reduction before and after 6 weeks of treatment | — |
| Magnitude of change and dose response of PGE2, NAG-1, and CRP in NAF before and after 6 weeks of treatment | — |
Countries
United States