Abstract. Background Preclinical (3) and epidemiological (4) studies suggest that the anti-inflammatory agent celecoxib also reduces BCa risk. Celecoxib inhibits COX2 through direct binding to the molecule, preventing the conversion of arachidonic acid to PGE 2 and other PGs (5). 1,25(OH) 2 D3 is also reported to alter the transforming growth factor (TGF)β pathway, which is important for the prevention and progression of breast carcinogenesis (6).Breast cells have the enzymatic machinery to convert 25(OH)D3 to 1,25(OH) 2 D3 (7). Increasing circulating levels of 25(OH)D3 is thought to result in an increased production of 1,25(OH) 2 D3 locally within breast cells, which, in turn, can affect their proliferation and differentiation (7).Thus, there is potential for a synergistic effect of improving the vitamin D status with celecoxib in the breast, with the local production of 1,25(OH) 2 D3 acting to reduce production of COX2, celecoxib to prevent the conversion of arachidonic acid to PGE 2 and 1,25(OH) 2 D3 also increasing the metabolism of the PGE 2 produced. We previously reported in a preliminary study that 2,000 IU vitamin D (but not vitamin D plus celecoxib) significantly decreased PGE 2 in the breast nipple aspirate fluid (NAF) of normal-risk women (8). To validate our preliminary findings and to determine if they also applied to women at increased breast cancer risk, we now report our findings of a larger cohort of normal-risk women, as well as a cohort of high-risk women who received placebo, 400 IU vitamin D3, 2,000 IU vitamin D3 or 2,000 IU vitamin D3 plus celecoxib. We also evaluated, vitamin D binding 5347