: Cytomorphology from breast random periareolar fine-needle aspirates can be used with the Gail risk model to identify a cohort of women at very high short-term risk for developing breast cancer. We recommend that cytomorphology be studied for use as a potential surrogate end point in prevention trials.

W Abstract: Proliferative breast disease is known t o be a common finding in women at risk for breast cancer. A group of 263 women defined as being at high risk for developing breast carcinoma underwent random fine-needle aspiration (FNA) of one or both breasts. In addition, a group of 30 low-risk volunteers underwent random FNA of one or both breasts. Using cytomorphologic criteria, only 29% of our high-risk group had normal (non-proliferative) cytology. Nine percent (9"/0) had apocrine metaplasia. Forty-three percent (43%) of high-risk women had proliferative breast disease with or without apocrine metaplasia and 19% had atypical hyperplasia (proliferative breast disease with atypia). In contrast, 83% of low-risk women had normal cytology, 17% had proliferative breast disease, and none had proliferative breast disease with atypia. The difference in prevalence of normal cytology, proliferative breast disease, and proliferative breast disease with atypia between women at high and low risk for developing carcinoma were all statistically significant (p < 0.01).Nine of the 263 women later developed in situ (n = 6) or invasive (n = 3) breast cancer. Eight of those 9 patients had proliferative breast disease with atypia on a prior random FNA and one had proliferative breast disease. These findings indicate that cytologic evidence of proliferative breast disease and proliferative breast disease with atypia from random FNA is more prevalent in highrisk than in low-risk women; and further that proliferative breast disease with atypia in the random needle aspirates is significantly associated with later cancer development.ine-needle aspiration (FNA) is considered to be a reli-F able diagnostic procedure in the evaluation of patients with palpable and/or mammographically detectable breast lesions (1-3). The technique is cost-effective, safe and, in experienced hands, has an encouraging level of diagnostic accuracy (4,s). Recently, FNA has been used to study and characterize cytologic material from nonpalpable breast lesions (4) as well as breast tissue in women considered at high risk for developing breast carcinoma on the basis of a positive family history ( 6 ) .In 1989 our group began a prospective study of cytologic characteristics and molecular abnormalities in a group of women at higher than normal risk for breast cancer development because of a first-degree relative with breast cancer, a prior contralateral breast cancer, or prior biopsy showing precancerous breast disease. The long term objective of our study is to identify, at a premalignant stage, those women in a high-risk population who will develop breast cancer within 5 years of initial testing. We present here the cytologic characteristics of FNAs from women at high risk as compared to those at low risk for developing breast carcinomas. Breast cancer development in those women is correlated with cytologic and epidemiologic variables.Eligible high-risk women were those without suspicious focal lesions by mammography who had a first-degree relative with breast...

This study aims to demonstrate the effect of omega-3 fatty acids (ω-3 FAs) supplements on the clinical manifestations, laboratory investigations, disease activity, functional capacity, response criteria as well as interleukin-1 (IL-1) and tumor necrosis factor-α (TNF-α) levels in juvenile idiopathic arthritis (JIA) patients. Twenty-seven JIA patients were included in this study. Dietary supplements of ω-3 FAs 2 g/day were given for 12 weeks. Juvenile arthritis disease activity score in 27 joints (JADAS-27) and pediatric American College of Rheumatology (ACR) response criteria were determined. Childhood Health Assessment Questionnaire (CHAQ) was used to measure the functional status. Assessment of serum IL-1 and TNF-α level was performed using enzyme-linked immunosorbent assay. The mean age of the patients was 12.78 ± 3.26 years, the disease duration was 5.93 ± 3.06 years, and the age at disease onset was 6.78 ± 3.26 years. The TNF-α and IL-1 were significantly higher in the JIA patients compared to the control. There was a significant improvement of active joint count, number of swollen joints, JADAS-27, CHAQ, TNF-α, and IL-1 levels. The pediatric ACR response criteria improved in 92.59% of the patients. The daily requirements of nonsteroidal anti-inflammatory drugs (NSAIDs) obviously decreased. ω-3 FAs supplements reduce the inflammatory response and improve the clinical manifestation in JIA patient. The daily intake of NSAID dose decreased thus reducing the risk of related side effects. Our results support the use of omega-3 fatty acids as an add-on therapy to conventional treatment of JIA.