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Inclusion Criteria: 1. Aged 19-49 2. Have physician-diagnosed asthma confirmed by the study physician examination, spirometry, methacholine challenge provocative concentration causing a 20% fall (PC20) of \<16 mg/mL, and questionnaires during a screening visit Exclusion Criteria: 1. Smoking of any kind (0.5 pack-years ever, or any current) or use of vape/vaporizing devices 2. Regular anti-histamine, NSAID, corticosteroid or other controller medication use 3. Pregnancy or breastfeeding 4. Methacholine PC20 \>16 5. Relevant cardiac condition or arrhythmia 6. Body mass index of \>35 7. Currently participating in another study that may interfere with this study 8. Use of either inhaled or oral corticosteroids in preceding 6 months 9. Substantial comorbidities on study physician's examination or other concerns 10. Surgery scheduled before anticipated study completion

Inclusion Criteria: Patient Usability Testing Inclusion Criteria: * History of a cancer diagnosis * At least 18 years of age * Male or Female * The ability to give informed consent in English or Spanish * Able to use and read a smartphone (iPhone or Android) * Has a smartphone (iPhone or Android) Community Usability Testing Inclusion Criteria: * At least 18 years of age * Male or Female * The ability to give informed consent in English or Spanish * Able to use and read a smartphone (iPhone or Android) * Has a smartphone (iPhone or Android) Focus Group and Interview Inclusion Criteria: * Completed chemotherapy treatment for stage I-III breast cancer. * Age 18 to 64 (inclusive) * Female * Paid employment (full time or part time) in the three months prior to diagnosis or at time of consent to MSK protocol #10-071 (PI: Blinder) * The ability to give informed consent in English or Spanish * Able to use and read a smartphone (iPhone or Android) * Has a smartphone (iPhone or Android) For Cohort 2: * Participants was covered by Emergency Medicaid at the time of diagnosis and/or at any point during their treatment for breast cancer RCT Inclusion Criteria: * Localized invasive breast cancer (not stage 0 or stage IV) per EMR or breast cancer (not stage 0 or stage IV) per self-report for community participants * If electronic medical record does not specify stage and patient is undergoing (neo)adjuvant chemotherapy, assume stage is I, II or III * Planning to undergo or undergoing adjuvant or neoadjuvant chemotherapy per EMR or planning to undergo or undergo chemotherapy per self-report for community participants * Age 18 to 64 (inclusive) * Female * Employment statue of (full time or part time) (those who are on disability leave/medical leave, and other unique employment circumstances at the PI's dicretion are eligible) * Language preference as English or Spanish * Able to use and read a smartphone or tablet (e.g. iPad, iPhone or Android) * Has access to a smartphone or tablet (e.g. iPad, iPhone or Android) Exclusion Criteria: RCT Exclusion Criteria: * Stage 0 breast cancer (DCIS only) * Stage IV (metastatic) breast cancer * Recurrence with metastases of breast cancer * Participants or family members who are participating in MSK IHCD studies related to social determinants of health

Inclusion Criteria: * Diagnosed with Major Depressive Disorder (MDD), single or recurrent episode, and currently experiencing a Major Depressive Episode (MDE) * Failed to achieve a satisfactory clinical response to at least one adequate antidepressant trial during the current depressive episode * Currently engaged in treatment with a mental health clinician Exclusion Criteria: * Axis I psychotic disorder (e.g. schizophrenia, bipolar I, depression with psychosis) * Axis I psychotic disorder in first degree relative * Currently taking a conventional antidepressant medication * Unstable medical or neurological conditions * Significant cognitive disorders * History of intolerance to drugs known to significantly alter perception e.g., psilocybin, LSD, salvinorin A, mescaline, etc. * Pregnant, breastfeeding, lack of adequate birth control * Urine toxicology positive to drugs of abuse on experimental test days

Inclusion Criteria: * At least 18 years old * Must be a patient of the UAB Dental School * Able to read and understand informed consent document * Good general health as evidenced by medical history * Minimum of 18 teeth, excluding third molars * Having moderate to severe periodontal disease according to AAP definition (teeth ≥5 mm PD and ≥3 mm CAL) * Having \>30 percent bleeding sites upon probing * Patients taking depression medication with chronic periodontitis * Patients without depression with chronic periodontitis * Patients who have not had a dental cleaning in the past 3 months prior to procedure * Patients scheduled for surgical procedures (i.e. gum surgery, tooth extraction, or dental implants) Exclusion Criteria: * Non-English speaking * Less than 18 years old * Smokers/tobacco users (\>10 cigarettes/day) * Any dental condition that requires immediate treatment, such as emergency care * Chronic use (≥3 times/week) of anti-inflammatory medications (e.g., non-steroidal anti-inflammatory drugs, steroids). Low-dose aspirin (less than 325 mg daily) * Immunocompromised subjects * Any medical history or any concomitant medication that might affect the assessment of the study treatment or periodontal tissues, such as uncontrolled diabetes, nifedipine, phenytoin (Dilantin), subjects with arthritis and morbidly obese (BMI ≥ 40)

Inclusion Criteria: * Female patients aged ≥ 18 years at time of inform consent signature. * Histologically proven HER2 positive breast cancer defined as 3+ staining intensity by immunohistochemistry (IHC) or a 2+ IHC staining intensity and HER2 gene amplification by FISH.Note: HER2 status will be determined as per institutional practice. * Operable breast tumor with tumor size and staging: \> 20 mm, cN0 or cN1, M0 before any AC or FEC chemotherapy, and at least one measurable lesion ≥10 mm in longest diameter at inclusion according to RECIST 1.1. * No radiological sign of disease progression at time of randomisation. * Patient previously treated by 4 cycles of AC or 3 to 4 cycles of FEC without febrile neutropenia and without prior pegfilgrastim treatment. * Availability of a representative formalin-fixed paraffin-embedded (FFPE) tumor specimen from initial diagnosis (i.e. an archival paraffin block is preferred; or at least 20 unstained slides) with its histological report. * Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2 * Adequate organ function as defined by the following lab tests (to be carried out within 7 days prior C1D1):Bone marrow (Absolute neutrophil count ≥ 1.5 x 109/L, Platelet count \> 100 x 109/L, (without transfusion within 21 days prior to C1D1), Hemoglobin value ≥ 9 g/dL), Renal function (Calculated creatinine clearance by MDRD or CKD-EPI \>50 mL/min/1.73m2 or serum creatinine \< 1.5ULN), Liver function (Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3ULN, Total serum bilirubin ≤ 1.5 ULN (except for patients with Gilbert disease for whom a total serum bilirubin ≤3 ULN is acceptable), Coagulation (INR and aPTT≤ 1.5 ULN) * Adequate cardiac function with Mean resting corrected QT interval (QTc), calculated using Fridericia's formula, ≤470ms obtained from 3 electrocardiograms (ECGs) and Systolic blood pressure \<160mmHg and Diastolic blood pressure \<100mmHg (hypertension controlled by standard medical treatment is allowed) * Women of childbearing potential (entering the study after a confirmed menstrual period and who have a negative pregnancy test within 7 days before C1D1) must agree to use two methods of medically acceptable forms of contraception from the date of negative pregnancy test to 3 months after the last study drug intake * Patients should be able and willing to comply with study visits and procedures as per protocol * Patients should understand, sign, and date the written voluntary informed consent form at the screening visit prior to any protocol-specific procedures performed. * Patients must be covered by a medical insurance. Exclusion Criteria: * Patients with inflammatory breast cancer. * Previous exposure to pegfilgrastim or trastuzumab. Note: the use of filgrastim (non pegylated form only) is authorized prior to the randomisation. * Patients requiring the concomitant use of any forbidden treatment including: Any other anti-cancer treatments not listed in the protocol, including chemotherapy, radiotherapy, immunotherapy, targeted therapy or biologic therapy for cancer treatment, Any investigational treatment. * Any contra-indication to trastuzumab, paclitaxel, and pegfilgrastim respective SPCs including:Hypersensitivity to trastuzumab, murine proteins, or to any of the excipients listed in trastuzumab SPC, Severe dyspnea at rest due to complications of advanced malignancy or requiring supplementary oxygen therapy, Hypersensitivity to pegfilgrastim or filgrastim, or to any of the excipients listed in SPC, Hereditary problems of fructose intolerance, Hypersensitivity to paclitaxel or to any excipient, particularly macrogolglycerol ricinoleate, Patients with history of or active cardiac disease including myocardial infarction (MI), angina pectoris requiring medical treatment, congestive heart failure NYHA (New York Heart Association) Class ≥II, other cardiomyopathy, cardiac arrhythmia requiring medical treatment, clinically significant cardiac valvular disease, and hemodynamic effective pericardial effusion. * Active secondary malignancy unless this malignancy is not expected to interfere with the evaluation of study endpoints and is approved by the sponsor. Examples of the latter include basal or squamous cell carcinoma of the skin, in-situ carcinoma of the cervix. Patients with a completely treated prior malignancy and no evidence of disease for ≥ 2 years are eligible. * Pregnant or breast-feeding female patients.

General Inclusion Criteria 1. Subject must have provided written Informed Consent 2. Subject must have biopsy-proven ductal carcinoma in situ (DCIS) or invasive ductal carcinoma of the breast a. In addition to invasive ductal carcinoma, allowable invasive carcinomas are: i. Adenoid cystic (or adenocystic) carcinoma ii. Low-grade adenosquamous carcinoma iii. Medullary carcinoma iv. Mucinous (or colloid) carcinoma v. Papillary carcinoma vi. Tubular carcinoma vii. Metaplastic carcinoma viii. Micropapillary carcinoma ix. Mixed carcinoma 3. Subject must be female ≥ 40 years of age 4. Subject's tumor(s) must be \< 3.0 cm in greatest diameter by pre-operative assessment 5. Clinical staging of Subject's tumor(s) must meet AJCC Tumor Classification: Tis, T1 or T2 (\< 3 cm), N0, M0 6. Subject presenting with bilateral breast cancer may be enrolled if BOTH cancers meet all of the inclusion and none of the exclusion criteria 7. Women of child-bearing potential must have a negative pregnancy test within one week of IORT treatment 8. Women of child-bearing potential must agree to use adequate contraceptive precautions (defined as intrauterine devices, surgical contraceptives or a combination of condom and spermicide) from the time of negative pregnancy test through completion of the radiation treatment period General Exclusion Criteria 1. Subject is pregnant or nursing 2. Subject has significant auto-immune disease 3. Subject has a pacemaker present in the field of radiation or quadrant of the breast cancer 4. Subject has multi-focal breast cancer where the sum of the individual tumor sizes (greatest diameters) are \> 3 cm Subject has multi-centric breast cancer 5. Subject has known lympho-vascular invasion 6. Subject has invasive lobular cancer 7. Subject has undergone neo-adjuvant chemotherapy or neo-adjuvant endocrine therapy for current breast cancer 8. Subject has a history of recurrent breast cancer in the ipsilateral breast 9. Subject has had previous radiation exposure of the involved breast 10. Subject has BRCA 1 or 2 mutations. Note: Testing will only be required for subjects presenting with bilateral breast cancer; testing is not required for unilateral cancers 11. Subject has contraindications for radiation 12. Subject considered by the Investigator to be high-risk for breast conservation surgery and/or intra-operative radiation therapy 13. Subject has participated in any other clinical investigation that is likely to confound study results or affect study outcome either at the time of IORT or for 3 months prior to IORT

Inclusion Criteria: * Females and males with Type 2 diabetes mellitus * Body Mass Index between 18 to 40 kg/m2, inclusive, at Screening * Hypomagnesemia defined as serum magnesium ≤ 1.5 mg/dL at Screening * Females must be non-pregnant, non-lactating, and have a negative serum pregnancy test before enrollment. Exclusion Criteria: * History of clinically significant GI, renal, hepatic, neurologic, hematologic, endocrine other than Type 2 diabetes mellitus, oncologic, pulmonary, immunologic, psychiatric, or cardiovascular disease.

Inclusion Criteria: * Age ≥19 * Able to provide written, informed consent * Able to attend an in-person study visit in Omaha, NE twice a year to collect blood samples * Must also meet criteria for one specific cohort. Participants who meet criteria for more than one cohort are eligible. (The intent being that potential participants must meet the criteria for at least one cohort, but are eligible if criteria are met for more than one cohort) o New onset diabetes/high-risk pre-diabetes cohort: must meet one of the following criteria: New onset type 2 diabetes diagnosed within the past 3 years, defined as A1c ≥ 6.5%, fasting blood glucose \>126mg/dL confirmed on a subsequent day or as diagnosed by a physician High-risk pre-diabetes: A1c \>6.3% or A1c \>6.0% with fasting blood glucose \>110 or 2 hour oral glucose tolerance test between 140-200mg/dL, or taken metformin \<3 years o Pancreatic cystic neoplasm/pancreatitis cohort: must have one of the following diagnoses: Pancreatic cystic neoplasm for which resection, endoscopic ultrasound (EUS) or serial imaging has been recommended Chronic pancreatitis as defined by cross-sectional imaging, endoscopic ultrasound, functional testing abnormalities OR as diagnosed by a gastroenterologist o Inherited risk cohort: must meet one of the following criteria: Two or more blood relatives with pancreatic ductal adenocarcinoma (PDAC), includes 1st-3rd degree relatives (First - parent, sibling or child; Second - grandparent, aunt/uncle, niece/nephew, or half-sibling; Third - first cousin, great grand parent or great grandchild) One 1st degree relative with PDAC diagnosed before age 60; Germline mutation associated with a higher than average risk of PDAC, including but not limited to: Hereditary breast and ovarian cancer syndromes (BRCA1, BRCA2, PALB2) Hereditary nonpolyposis colon cancer (Lynch) syndrome (MLH1, MSH2, MSH6, PMS2) Familial adenomatous polyposis (APC) Familial atypical multiple melanoma and mole syndrome (CKDN2a, p16) Peutz-Jeghers syndrome (STK11) Ataxia-telangectasia (ATM) Juvenile polyposis syndromes (SMAD4, BMPR1A) Li Fraumeni (TP53) Cystic fibrosis and unaffected carriers (CFTR) Personal or family history which meets clinical criteria for a hereditary cancer syndrome and includes a relative with PDAC (as above) Exclusion Criteria: * Personal history of pancreatic ductal adenocarcinoma (PDAC) * Currently receiving treatment for a cancer diagnosis (excluding long-term hormonal therapy) * Pre-diabetes on metformin for ≥ 3 years

Inclusion Criteria: * Body Mass Index (BMI) \>= 27 kg/m\^2. * At high risk of developing breast cancer defined by one or more of the following: Gail model lifetime risk \> 20% or a 5 year risk \>1.66%, a history of deleterious BRCA1/2 mutation or mantle radiation, a history of ductal cancer in situ, or a history of high risk premalignant breast lesion. * 12 months without a period/menstrual cycle or having had a bilateral oophorectomy. * Ability to take digital time stamped photos. * Internet access (daily). * Reports being proficient in English (can read/write and speak fluently). Exclusion Criteria: * Previous participation in this trial. Participation is defined as screening. Re-screening is not allowed except for individuals excluded for BMI. Patients previous screened as ineligible due to BMI are allowed to be re-screened and enrolled if eligible. * Has a current measured BMI less than 27 kg/m\^2. * Reports being unwilling to use Continuous Glucose Monitor (CGM), which requires daily blood sampling by finger pricks. * Currently being actively treated for cancer other than nonmelanoma skin cancer. * Known inability to participate in the ongoing appointments for the four months of the study and scheduled follow-up tests. * Reported current diagnosis or history of type I diabetes or type 2 diabetes. * Reported use of oral antidiabetic agents (OADs). * Current use of any drug (except metformin) or anticipated change in concomitant medication, which the investigator's opinion could interfere with the glucose metabolism (e.g. systemic corticosteroids). * Previous or current treatment with any insulin regimen other than basal insulin, e.g. prandial or pre-mixed insulin (short term treatment due to intercurrent illness including gestational is allowed at the discretion for the investigator). * Previous or current treatment with GLP-1 receptor agonists (e.g. exenatide, liraglutide). * Fasting blood glucose level \> 126 and glycosylated hemoglobin (HbA1c) \> 7%. * Subjects considered by the investigator as unsuitable for the study for reasons not otherwise stated.

Inclusion Criteria: * Children and adolescents aged 0-16 years * Resident in Switzerland * Seen in a paediatric pulmonary outpatient clinic due to respiratory problems * Parents and patients above age 14 must be able to sign an informed consent form Exclusion Criteria: Prior diagnosis of cystic fibrosis, primary ciliary dyskinesia, severe heart disease, oncological disease, neuromuscular disease or severe disability

Inclusion Criteria: * \> 10 weeks of pregnancy, primipara and multipara Exclusion Criteria: * \< 10 weeks of pregnancy and congenital malformations of the fetus

Inclusion Criteria: * MD Anderson patient between the ages of 18 to 65 * Current smoker (i.e., at least 1 cigarette or e-cigarette per day) * Smoking for at least one year * Willing to set a quit date in the next 30 days * Not engaged in smoking cessation treatment other than the MDACC Tobacco Treatment Program * Currently elevated depressive symptoms or a history of elevated depressive symptoms; (PHQ 2 = or \> 1); current or past * English speaking and ability to read and comprehend English * Currently own an iOS mobile phone or tablet (iPhone; iPad) using iOS 9.0 or later and reports regular use (at least weekly) of at least 1 iOS app Exclusion Criteria: * Any medical or psychiatric condition, illness, disorder, or concomitant medication that could compromise participant safety or treatment, as determined by the Principal Investigator or Collaborator * Subject considered by the investigator an unsuitable candidate for receipt of a smoking cessation treatment or unstable to be followed up throughout the entire duration of the study

Inclusion Criteria * Women aged at least 18 years; * Patients must be able to provide informed consent and sign the informed consent form to participate in the RDA study before any study procedures starts; * Newly diagnosed clinical stage I, II or III breast cancer with complete surgical excision of the breast cancer after neoadjuvant therapy as the treatment goal; * Tumour size at least 1 cm in one dimension by clinical or radiographic exam (WHO criteria); * Must have histological confirmation of invasive breast cancer of any subtype or grade; * Patient is scheduled for neoadjuvant chemotherapy +/- antibodies and +/- other drugs according to Standard of Care; * Patient willing to have 2 research core needle biopsies (for RDA) taken at 2 collection timepoints during neoadjuvant chemotherapy treatment. Exclusion Criteria * Patient who has had prior local (i.e. surgery or radiotherapy) or systemic (i.e. endocrine or cytotoxic) therapy for the current breast cancer; * Participation in another interventional clinical trial with concurrent treatment with experimental drugs to treat the current breast cancer during the period of neoadjuvant therapy (from diagnosis until surgery); * Stage IV breast cancer; * Bilateral or multicentric breast tumour; * Prior malignant disease except curatively treated in-situ maligancies; * Concurrent pregnancy; * Breast feeding woman; * Concurrent medical, psychiatric or addictive disorders that may limit the ability to give informed consent or complete the trial; * Reasons indicating risk of poor compliance with study procedures; * Patient not able to consent;

Eligibility criteria for study villages: * The village has a regular village doctor who is willing to participate in the hypertension control project * The village does not plan to merge with other villages within 3 years * The village is at least 2 kilometers away from other participating villages * The village participates in the China New Rural Cooperative Medical Scheme Eligibility criteria of study participants: * Men or women aged ≥40 years * Mean untreated systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg or mean treated systolic BP ≥130 mm Hg and/or diastolic BP ≥80 mm Hg for individuals without a history of clinical CVD; or mean treated/untreated systolic BP ≥130 mm Hg and/or diastolic BP ≥80 mm Hg for individuals with a history of clinical coronary heart disease, heart failure, stroke, diabetes, or chronic kidney disease * Have lived in a participating village for at least 6 months * No intention to migrate within next 3 years * Taking part in the New Rural Cooperative Medical Scheme * Not pregnant or planning to become pregnant * No malignant tumors and life expectancy ≥3 years * Willing to participate and able to sign informed consent

Inclusion Criteria 1. Singleton gestation. Twin gestation reduced to singleton, either spontaneously or therapeutically, is not eligible unless the reduction occurred before 14 weeks project gestational age. 2. Gestational age at randomization between 14 weeks 0 days and 21 weeks 6 days based on clinical information and evaluation of the earliest ultrasound. 3. Diagnosis with mild to moderate OSA as defined by an AHI score ≥ 5 and \<30. Exclusion Criteria 1. Previously prescribed, current or planned therapy for sleep apnea. 2. Age \< 18 years, because the rate of sleep apnea in this population is extremely low. 3. Inability to sleep in a stable place with access to the CPAP machine at least 5 nights per week. 4. Asthma requiring systemic steroid therapy for more than 14 days within the past 6 months because this population is expected to be unresponsive to CPAP therapy. 5. Current use of prescribed sleeping pills for insomnia. 6. Chronic medical conditions requiring oxygen supplementation (e.g. pulmonary fibrosis, pulmonary hypertension, cystic fibrosis) because this population is expected to be unresponsive to CPAP therapy. 7. Chronic renal disease with serum creatinine \>1.3 mg/dL because the primary outcome would be pre-determined. 8. Antiphospholipid antibody syndrome, because it would compromise the primary outcome diagnosis. 9. History of medical complications such as: 1. Active liver disease (acute hepatitis, chronic active hepatitis, persistently abnormal liver enzymes) 2. Thrombocytopenia with platelet count \<100,000 because of the difficulty in assessing the primary outcome. 10. Active vaginal bleeding (more than spotting) at the time of randomization. 11. Known chromosomal, genetic, major malformations or fetal demise, or planned termination of pregnancy because inclusion would compromise evaluation of secondary neonatal outcomes. 12. Known major uterine malformations associated with adverse pregnancy outcomes. 13. Current use of opiates (heroin, methadone, or other daily opioid use) due to inaccuracy of the home sleep test and inefficiency of CPAP. 14. Active drug use, alcohol use, or unstable psychiatric condition. 15. Participation in another interventional study that influences preeclampsia, hypertensive disorders of pregnancy, or GDM. 16. Prenatal care or delivery planned at a non-network center where access to the complete electronic medical record will not be available to research staff. 17. Participation in this trial in a previous pregnancy. Patients who were screened in a previous pregnancy, but not randomized, may be included.

Inclusion Criteria: * Are capable of giving informed consent * Are of any race or ethnicity * Are fluent in written and spoken English * Whose history and physical exam did not uncover any exclusion criteria * Are 18 years of age For subjects with elevated standing BP * Systolic BP (SBP) during standing is at least 10 mmHg \> the supine SBP * Patients with a diagnosis of stage I hypertension without other chronic diseases may be INCLUDED For normal subjects without elevated standing BP * The change in SBP by standing is within ± 5 mmHg from the supine SBP * Matched gender, similar age and BMI (within 10%) to participants with elevated standing BP * Free of acute or chronic medical conditions Exclusion Criteria: * Age \< 18 years of age * Are a pregnant or nursing woman * Are a prisoner or institutionalized individual or unable to consent * Have chronic diseases (e.g. heart, lung, neuromuscular disease, or cancer) other than stage I hypertension * Have orthostatic hypotension or a history of syncope * Current smoker * History of blood clots

Inclusion Criteria: * age \>= 18 years * Posterior Reversible Encephalopathy Syndrome defined as: * combination of consciousness impairment, seizure activity, headaches, visual abnormalities, nausea/vomiting, and focal neurological signs AND * cerebral imaging abnormalities involving the white matter (brain CT scan hypodensities AND/OR Brain MRI hypoT1, hyper T2 FLAIR) * intensive care unit admission Exclusion Criteria: * normal cerebral imaging

Inclusion Criteria: * Be willing and able to provide written informed consent/assent for the trial * Have a diagnosis of a tumor with evidence of genomic instability on Clinical Laboratory Improvement Amendments (CLIA) certified genomic testing, inclusive of mutations in POLE, POLD1 for arm 1 and in BRCA1 and BRCA2 for arm 2; in arm 2, enrollment of breast and ovarian histologies will be limited to a total of 10 patients * Have advanced cancer (metastatic, recurrent or locally advanced) and measurable disease based on Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 * Be willing to provide archived tumor tissue; tissue from the most obtained core or excisional biopsy of a tumor lesion is preferred; 20 unstained slides are preferred but a minimum of 15 slides will be acceptable; if adequate tissue is not present the patient may consent to a newly obtained biopsy * Have a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) performance scale * Absolute neutrophil count (ANC) \>= 1,500 /mcL, performed within 10 days of treatment * Platelets \>= 100,000 / mcL, performed within 10 days of treatment * Hemoglobin \>= 9 g/dL or \>= 5.6 mmol/L without transfusion or erythropoietin (EPO) dependency (within 7 days of assessment), performed within 10 days of treatment * Serum creatinine =\< 1.5 X upper limit of normal (ULN) OR Measured or calculated creatinine clearance \>= 60 mL/min for subject with creatinine levels \> 1.5 X institutional ULN (glomerular filtration rate \[GFR\] can also be used in place of creatinine or creatinine clearance \[CrCl\]), performed within 10 days of treatment * Serum total bilirubin =\< 1.5 X ULN OR direct bilirubin =\< ULN for subjects with total bilirubin levels \> 1.5 ULN, performed within 10 days of treatment * Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase \[SGOT\]) and alanine aminotransferase (ALT) (serum glutamic pyruvic transaminase \[SGPT\]) =\< 2.5 X ULN OR =\< 5 X ULN for subjects with liver metastases, performed within 10 days of treatment * Albumin \>= 2.5 mg/dL, performed within 10 days of treatment * International normalized ratio (INR) or prothrombin time (PT) =\< 1.5 X ULN unless subject is receiving anticoagulant therapy as long as PT or partial thromboplastin time (PTT) is within therapeutic range of intended use of anticoagulants, performed within 10 days of treatment * Activated partial thromboplastin time (aPTT) =\< 1.5 X ULN unless subject is receiving anticoagulant therapy as long as PT or PTT is within therapeutic range of intended use of anticoagulants, performed within 10 days of treatment * Female subject of childbearing potential should have a negative urine or serum pregnancy within 72 hours prior to receiving the first dose of study medication; if the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required * Female subjects of childbearing potential should be willing to use 2 methods of birth control or be surgically sterile, or abstain from heterosexual activity for the course of the study through 120 days after the last dose of study medication; subjects of childbearing potential are those who have not been surgically sterilized or have not been free from menses for \> 1 year * Male subjects should agree to abstinence or use of an adequate method of contraception starting with the first dose of study therapy through 120 days after the last dose of study therapy Exclusion Criteria: * Is currently participating and receiving study therapy or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks of the first dose of treatment * Has a diagnosis of immunodeficiency that requires receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment or has resulted in life threatening episodes previously regardless of current treatment * Has a known history of active TB (Bacillus tuberculosis) * Hypersensitivity to pembrolizumab or any of its excipients * Has had a prior anti-cancer monoclonal antibody (mAb) within 4 weeks prior to study day 1 or who has not recovered (i.e., =\< grade 1 or at baseline) from adverse events due to agents administered more than 4 weeks earlier * Has had prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to study day 1 or who has not recovered (i.e., =\< grade 1 or at baseline) from adverse events due to a previously administered agent * Note: Subjects with =\< grade 2 neuropathy are an exception to this criterion and may qualify for the study * Note: If subject received major surgery, they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting therapy * Has a known additional malignancy that is progressing or requires active treatment; exceptions include basal cell carcinoma of the skin or squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer, or malignancies that have been inactive for three years or exceptionally indolent; any current diagnosis of second malignancy requires approval from principal investigator and sponsor * Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis; subjects with previously treated brain metastases may participate provided they are stable (without evidence of progression by imaging for at least four weeks prior to the first dose of trial treatment and any neurologic symptoms have returned to baseline), have no evidence of new or enlarging brain metastases, and are not using steroids for at least 30 days prior to trial treatment; patients who had oligometastatic disease treated with stereotactic radiation or gamma knife therapy may receive treatment 14 days after therapy as long as they are not requiring steroids; this exception does not include carcinomatous meningitis which is excluded regardless of clinical stability * Has active autoimmune disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs); replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment * Has known history of, or any evidence of active, non-infectious pneumonitis * Has an active infection requiring systemic therapy * Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject?s participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator * Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial * Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting with the pre-screening or screening visit through 120 days after the last dose of trial treatment * Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent * Has a known history of human immunodeficiency virus (HIV) (HIV 1/2 antibodies) * Has received a live vaccine within 30 days of planned start of study therapy * Note: Seasonal influenza vaccines for injection are generally inactivated flu vaccines and are allowed; however intranasal influenza vaccines (e.g., Flu-Mist) are live attenuated vaccines, and are not allowed * Tumors harboring non-hotspot POLE or POLD1 mutations that show clear evidence of microsatellite instability (MSI) will be excluded * Has known active hepatitis B (e.g., hepatitis B surface antigen \[HBsAg\] reactive) or hepatitis C (e.g., hepatitis C virus \[HCV\] ribonucleic acid \[RNA\]

Inclusion Criteria: * Age older than 18 * Eastern Cooperative Oncology Group (ECOG) performance status 0-1 * Men and/or pre- or post-menopausal women with metastatic breast cancer with at least 2 intracranial untreated and measurable (≥ 3mm) metastases as visualized on brain MRI * A diagnostic contrast enhanced MRI demonstrating at least 2 lesions in the brain, (≥3mm in size), performed within two weeks prior to treatment * Maximum diameter of treated lesions should be \<4cm in size * Have measurable disease based on RECIST 1.1. Lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions. * Patient needs to be able to understand and demonstrate willingness to sign a written informed consent document * Prior SRS is permitted, however the lesions targeted for treatment on trial need to be previously untreated by SRS * Patients who have undergone prior subtotal resection are eligible providing that residual disease is \<4cm in maximum diameter: the cavity will be treated as standard of care. * Continuing a concurrent use of hormonal therapy or anti-Her2 neu therapy is allowed, if the patient exhibits brain metastases progression during these treatments * Enrolled patients should have a two-week washout period from last systemic treatment * The participant (or legally acceptable representative if applicable) provides written informed consent for the trial. * Contraception duration of 120 days * Adequate bone marrow reserve and liver function Exclusion Criteria: * Active connective tissue disorders, such as lupus or scleroderma requiring flare therapy * Patients who have undergone complete resection of all known brain metastases * Inability to obtain histologic proof of breast cancer * Target lesion metastasis within 5mm of the optic apparatus so that some portion of the optic nerve or chiasm would be included in the SRS field * Has received prior radiotherapy within 2 weeks of start of study treatment. Participants must have recovered from all radiation-related toxicities, not require corticosteroids, and not have had radiation pneumonitis. A 1-week washout is permitted for palliative radiation (≤2 weeks of radiotherapy) to non-CNS disease. * Has received a live vaccine or live-attenuated vaccine within 30 days prior to the first dose of study drug. Administration of killed vaccines is allowed. * Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks prior to the first dose of study treatment. * Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of study drug. * Has a known additional malignancy (second primary) that is progressing or has required active treatment within the past 3 years. Note: Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ (e.g. cervical cancer in situ) that have undergone potentially curative therapy are not excluded. * Has severe hypersensitivity (≥Grade 3) to pembrolizumab and/or any of its excipients. * Has active autoimmune disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (eg., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment. * Has a history of (non-infectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis. * Has an active infection requiring systemic therapy..Has a known history of Human Immunodeficiency Virus (HIV). * Has a known history of Hepatitis B (defined as Hepatitis B surface antigen \[HBsAg\] reactive) or known active Hepatitis C virus (defined as HCV RNA \[qualitative\] is detected) infection. Note: no testing for Hepatitis B and Hepatitis C is required unless mandated by local health authority. * Has a known history of active TB (Bacillus Tuberculosis). * Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial. * Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of trial treatment.

Inclusion Criteria: For cancer patients, eligibility includes: * being female * Age 60+ at diagnosis of a new primary histological confirmed adenocarcinoma breast cancer * AJCC stages 0-3 or planning neoadjuvant therapy * In the judgment of the consenting professional, able to communicate well enough in English through verbal and written communication to complete the study assessments and provide informed consent * If currently taking psychoactive medications (including, but not limited to anticonvulsants, antidepressants, and anxiolytics), dose must have been stable at least two months prior to enrollment. * Participant report of no previous or current chemotherapy or hormonal treatment use (anastrazole, exemestane, etc.) This does not include hormonal replacement therapy, synthetic thyroid hormones, etc. For controls, eligibility includes: * being female * Age 60+ * In the judgment of the consenting professional, able to communicate well enough in English through verbal and written communication to complete the study assessments and provide informed consent * If currently taking psychoactive medications (including, but not limited to anticonvulsants, antidepressants, and anxiolytics), dose must have been stable at least two months prior to enrollment. Exclusion: We apply the same exclusion criteria for patients and controls. * Participant report of a history of formal diagnosis of neurological problems (i.e. Alzheimer's disease, Parkinson's disease, Multiple Sclerosis, Dementia, Seizure Disorders, brain tumors, etc.) * Participant report of surgery on the brain for any reason (cancerous or non-cancerous tumors, subdural hematomas, AV malformations, increased intracranial pressure, etc.) * Participant report of a history of stroke (with the exception of TIA if ≥1 year ago) * Participant report of HIV/AIDS * Participant report of moderate to severe head trauma (loss of consciousness \> 60 min or with evidence of structural brain changes on imaging) * History of major psychiatric disorder (DSM-IV Axis 1) (i.e. major depressive disorder (untreated or poorly treated), bipolar disorders, schizophrenia, or substance abuse disorders (self-reported and/or stated in medical record). * Participant report of a history of prior breast or other cancer with the exception of non-melanoma skin cancer. An exception for cases only: women who completed treatment for a previous cancer at least 5 years ago and have not undergone any chemotherapy or hormonal therapy. This previous cancer cannot be breast cancer. * Participant report of previous or current chemotherapy or hormonal therapy use * Participant use of methotrexate (Amethopterin, Rhematrex, Trexall) or rituximab (Rituxin) for rheumatoid arthritis, psoriasis or Crohn's disease, or cyclophosphamide (Cytoxan, Neosar) for Lupus. * Visual or hearing impairment that would preclude ability to complete interviews or neuropsychological testing, such as significant macular degeneration or being unable to correct hearing with hearing aides * Non-English speaking * To participate in the optional neuroimaging portion of the study: Participant cannot be claustrophobic Participant cannot have a pacemaker, aneurysm clip or other implants that are not MRI safe Participant cannot have any type of implanted electrical device