This text describes a system of reporting breast fine needle aspiration biopsy that uses five clearly defined categories, each described by a specific term and each with a specific risk of malignancy. The five categories are insufficient/inadequate, benign, atypical, suspicious of malignancy and malignant. Each category has a risk of malignancy and is linked to management recommendations, which include several options because it is recognized that diagnostic infrastructure, such as the availability of core needle biopsy and ultrasound guidance, vary between developed and low and middle income countries. This text includes key diagnostic cytological