Celecoxib in Preventing Breast Cancer in At-Risk Premenopausal Women

DISEASE CHARACTERISTICS:

• Increased risk for breast cancer on the basis of at least 1 of the following criteria:

  • Five-year Gail risk at least 1.7% or a calculated risk at least 5 times the average for age group

    • 20-29 years old - calculated 5-year Gail risk is at least 0.1%
    • 30-39 years old - calculated 5-year Gail risk is at least 1.0%
    • 40 and over - calculated 5-year Gail risk is at least 1.7%
  • Known BRCA1/BRCA2 mutation carrier

  • Family history consistent with hereditary breast cancer, as defined by any of the following circumstances:

    • At least 4 relatives with breast cancer at any age
    • At least 2 first-degree relatives diagnosed with breast cancer at age 50 or younger
    • Breast and ovarian cancer diagnosed in the same relative
    • At least 2 occurrences of breast cancer and 1 occurrence of ovarian cancer at any age in the same family
  • Prior biopsy exhibiting atypical hyperplasia, lobular cancer in situ, ductal carcinoma in situ (DCIS)*, or invasive cancer** NOTE: *If DCIS or T1a or T1b disease was found, at least 2 months must have elapsed since prior surgery and/or radiotherapy to the involved breast

NOTE: **Prior invasive cancer (T1c, T2, or T3) must have been diagnosed at least 2 years before study and be estrogen receptor-negative, node negative

• Must have had a random periareolar fine needle aspiration successfully performed within the past 3 months, with at least 1,000 cells on cytology slide and 3 additional slides for biomarker analysis (1 with at least 500 cells for Ki-67 and 2 with at least 100 ductal cells for estrogen receptors and COX-2)

• Hormone receptor status:

  • Estrogen receptor negative

PATIENT CHARACTERISTICS:

Age

• 18 to 55

Sex

• Female

Menopausal status

• Premenopausal, defined as menstrual periods estimated to occur every 21 to 35 days over the past 6 months

Performance status

• Not specified

Life expectancy

• At least 5 years

Hematopoietic

• Absolute granulocyte count at least 1,000/mm^3
• Platelet count at least 100,000/mm^3
• Hemoglobin at least 10 g/dL
• No bleeding diathesis within the past year

Hepatic

• Bilirubin no greater than 2.0 mg/dL
• Albumin at least 3.0 g/dL
• AST and ALT no greater than 2 times upper limit of normal (ULN)
• Alkaline phosphatase no greater than 2 times ULN
• No severe liver disease requiring treatment

Renal

• Creatinine no greater than 1.5 mg/dL

Cardiovascular

• No high blood pressure not controlled by medication
• No history of angina
• No history of cardiovascular disease
• No history of deep vein thrombosis

Pulmonary

• No history of pulmonary embolism

Other

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No prior allergy to sulfa, COX-2 inhibitors, or nonsteroidal anti-inflammatory drugs (NSAIDs)
• No history of an ulcer requiring treatment
• No history of ulcerative colitis
• No inflammatory bowel disease
• No body mass index > 33
• No history of diabetes
• No prior metastatic malignancy of any kind
• No complications of alcoholism requiring hospitalization
• No concurrent asthma being treated

PRIOR CONCURRENT THERAPY:

Biologic therapy

• Not specified

Chemotherapy

• At least 6 months since prior chemotherapy

Endocrine therapy

• At least 6 months since prior antihormone therapy (e.g., selective estrogen-receptor modulators or aromatase inhibitors)
• Anticipated use of oral or IV corticosteroids must be less than 2 weeks per year
• No change (stop or start) in hormonal therapy within the past 6 months (e.g., estrogen, progesterone, oral contraceptives, or fertility agents)

Radiotherapy

• See Disease Characteristics
• No prior radiotherapy to the contralateral breast involved in the study treatment

Surgery

• See Disease Characteristics

Other

• At least 3 weeks since prior aspirin, rofecoxib, celecoxib, other COX-2 inhibitors, or NSAIDs
• No concurrent anticoagulants
• No other concurrent NSAIDs
• No chronic angiotensin-converting enzyme inhibitors
• No chronic furosemide*
• No chronic fluconazole*
• No chronic lithium NOTE: *Occasional concurrent use allowed