Transdermal or Oral Telapristone Acetate in Treating Patients Undergoing Mastectomy

Inclusion Criteria:

* Women scheduled for unilateral or bilateral mastectomy for breast cancer therapy, pathology confirmed stage 0-II (including ductal carcinoma in situ), or prophylaxis (breast cancer, early onset \[BRCA\] mutation carriers, women with strong family history or lobular carcinoma in situ or other conditions where prophylactic mastectomy has been elected)
* Eastern Cooperative Oncology Group (ECOG) performance status =\< 1 (Karnofsky \>= 70%)
* Total bilirubin \< 1.5 x upper limit of normal (ULN)
* Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase \[SGOT\]) \< 2.5 x ULN
* Alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) \< 2.5 x ULN
* Creatinine \< 2 x ULN
* Alkaline phosphatase \< 2.5 x ULN
* Blood urea nitrogen \< 2 x ULN
* Willing to use non-hormonal contraception (adequate barrier-type contraception or intrauterine device \[IUD\]) from the time the pregnancy test is performed for the duration of study participation, and 30 days after study drug cessation (for women of childbearing potential only)
* Ability to understand and the willingness to sign a written informed consent document
* Willing and able to schedule mastectomy 4 weeks (+/- 7days) following start of study agent
* Willing to avoid exposing breast skin to natural or artificial sunlight (i.e. tanning beds) for the duration of study agent dosing
* Negative urine pregnancy test result, for participants of child bearing potential, within 5 days prior to first dose of study medication; female of child-bearing potential is any woman (regardless of sexual orientation, whether she has undergone a tubal ligation, or remains celibate by choice) who meets the following criteria: has not undergone a hysterectomy or bilateral oophorectomy; OR has had a menstrual period at any time in the preceding 12 consecutive months)
* Willing to use alcohol in moderation while taking study agent

Exclusion Criteria:

* The presence of skin invasion by the breast cancer, or inflammatory changes with skin edema AND erythema. Note: Paget's disease is permitted.
* Women receiving a "nipple delay" procedure prior to mastectomy.
* Women with skin diseases (psoriasis, eczema) on breast.
* A history of thromboembolic disorder or cerebral vascular disease
* Use of oral contraceptives or other hormonal treatments within eight weeks prior to the randomization or during the period of the study; women should not have used Depo-Provera in the preceding 6 months; use of hormone coated IUD like Mirena is allowed
* Participants may not have received any other investigational agents in the previous 3 months
* History of allergic reactions attributed to compounds of similar chemical or biologic composition to telapristone (i.e. other progesterone antagonists)
* Taken tamoxifen or other selective estrogen/progesterone receptor modulators (SERMs/SPRMs) within two years prior to entering study or been required to discontinue SERM therapy due to thromboembolic or uterine toxicity
* Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
* History of prior breast cancer-specific therapy within the previous 2 years; previous unilateral radiation in women scheduled for mastectomy of the contralateral side is allowed
* Pregnant or breastfeeding
* Currently taking spironolactone
* Recent history (within 6 months) of alcoholism or drug abuse
* Known active infection with human immunodeficiency virus (HIV), hepatitis A, B, or C