Background: Breast lump is one of the commonest complaints with which patients present in breast clinics. As approximately 10% of breast masses ultimately lead to a diagnosis of breast cancer, it is important for women with a breast lump to receive appropriate evaluation. A confident diagnosis can be made in 95% of the cases through a combination of clinical examination, imaging and fine needle aspiration cytology. Histopathology is the gold standard for diagnosis.Methods: This is a prospective study conducted in the Department of Pathology, K.V.G Medical College, Sullia on 50 patients who presented with clinically palpable breast lump. Patients were subjected to sonomammography and Breast Imaging Reporting and Data System (BIRADS) scoring followed by FNAC and histopathological examination. Sensitivity, specificity, accuracy, positive and negative predictive values of sonomammogram in relation to the BIRADS score and FNAC taking histopathology as the gold standard was calculated.Result: FNAC had significantly higher sensitivity, specificity, positive and negative predictive values and accuracy compared to sonographical diagnosis using BIRADS score.Conclusion: FNAC could be considered as the first method to evaluate breast lesions, recognized by means of imaging techniques.