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Tissue biomarkers may be helpful to determine changes in the environment of the breast that are predictive of breast cancer occurrence. Random periareolar fine needle aspiration (RPFNA) is a novel technique that obtains random small tissue samples from above the periareolar region of the breast. Obtained material provides tissue from epithelial cell lines for cytologic examination with description of cellular components. In this study, RPFNA was used to obtain small mammary tissue samples from women at increased risk of breast cancer development based on personal and family history and genetic mutations. In some participants, serial samples occurred at a biannual or annual basis which allowed for observation of cellular changes over time. The Masood scale (scale of 6-24) was used by a single cytopathologist to score the mammary tissue. We compared demographic data and Masood scores to other markers identified in the samples that were indicative of cellular changes and inflammation. These findings were also compared to clinical outcomes. Preliminary data analyses are pending.