BACKGROUNDPalpable breast lumps are a common occurrence in women all over the world. The prevalence of non-neoplastic and neoplastic lesions varies from region to region. Fine Needle Aspiration Cytology (FNAC) is a rapid, minimally invasive, reliable and relatively simple diagnostic method. We wanted to study the frequencies of different lesions in FNAC of breast lump in our region and to observe cyto-histological correlation wherever possible. METHODSA two years prospective study was carried out in the department of pathology, RIMS, Imphal during the period January 2016 -December 2017. A total of 434 cases of breast lesions were encountered during this period. RESULTSOf the total 434 cases infectious/inflammatory lesions were 100 (23.1%), benign 268 (61.7%), malignant 40 (9.2%), suspicious for malignancy 02 (0.5%), unsatisfactory 18 (4.1%), and others 6 (1.4%). The most frequent infectious/inflammatory lesion was acute mastitis in 50 (11.5%) followed by sub-areolar abscess in 17 (3.9%) and fat necrosis in 17 (3.9%). Fibroadenoma in 142 (32.7%) cases was the most common benign breast lesion followed by benign proliferative breast lesion without atypia 14 (22.1%). Among the malignant, 39 (9%) cases were carcinoma and one case (0.2%) was lymphoma. Mean age of presentation was 32.82 years. Most commonly involved age group was 21-30 years and right breast was more commonly involved. Cytohistological correlation was done in 41 cases and 35 benign and 6 malignant cases diagnosed cytologically were confirmed by histology, though there were cases with variable diagnosis. So, in differenting benign from malignant lesions, the sensitivity, specificity, positive predictive value, negative predictive value was 100%. CONCLUSIONSFNAC is a reliable and rapid diagnostic tool in the workup of breast lesions. It also helps in differentiating between benign and malignant breast lesions and plays an important role in management of the patient. KEYWORDSFNAC, Breast lump, Neoplastic HOW TO CITE THIS ARTICLE: Das KK, Khuraijam SD, Khuraijam S, et al. Cytological spectrum of female breast lesions in a tertiary centre: a two years study.