<p>Breast carcinoma is the most common malignancy in women and ranks first among malignant tumors throughout the world. Timely diagnosis of breast lesions is life saving for women. Fine needle aspiration cytology (FNAC) is an important part of triple approach for diagnosing the breast lesions. It is a simple, rapid, highly sensitive, specific, inexpensive method and is used as a first line diagnostic approach for evaluation of breast lesions and for deciding the treatment. A 3-year retrospective study was carried out from Jan 2021–Dec 2023 in the department of pathology at a tertiary care hospital in Ganganagar among 141 patients who presented with a breast lump. All breast lump cases were evaluated with FNAC and categorized according to IAC Yokohama classification, and histopathological diagnosis was also retrieved and correlated in all cases wherever available. The associated risk of malignancy (<i>ROM</i>) was also calculated for each category. The. aims are (1) to diagnose and categorize any palpable breast lump on cytology by IAC Yokohama reporting system and ( 2) to correlate the cytological diagnosis with histopathological findings. The present study includes 141 cases, of which 107 cases were benign, and 34 cases were malignant. Out of these 141 cases, 108 cases underwent surgical exploration and were correlated with histopathology. The sensitivity, specificity, positive predictive value, and negative predictive value of these cases were 95%, 98.5%, 97.4%, and 97%, respectively. Risk of malignancy was calculated for each cytological category which was maximum for C5 (100%) and C1 (100%), followed by C4 (80%), C3 (25%), and the <i>ROM</i> was (0%) for C2 category. FNAC serves as a rapid, reliable, and preliminary tool for evaluation of breast lumps, and the results show a high degree of correlation with the histopathological report.</p>