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Purpose:Lactating adenoma is the most common lesion found in a pregnant or a puerperal lady. Apart from its occurrence in normally located breasts, it has also been reported in ectopic breast that may be located anywhere along the milk line. Often it presents as a firm and palpable mass. Prompt diagnosis is possible with help of Fine needle aspiration cytology (FNAC). This study was carried out with the aim of studying the panorama of various such breast lesions on FNAC in our setup. Correlation with sonomammography was also performed. Materials and Methods: This was a four year prospective study carried out from May 2010 to February 2014. Palpable breast mass in any lactating lady was first evaluated by sonomammography. FNAC was then performed and the smears were stained with MGG and Papanicolaou stain. Results:Out of the 14 palpable breast masses in lactating women that were diagnosed as lactating adenoma on sonomammography, 05 were found to be tense galactoceles and 09 were found to be lactational adenomas. Panorama of lactational adenomas showed 4 distinct patterns. Pattern A( 04 cases): low columnar epithelium, No necrotic areas or cytoplasmic vacuoles.Pattern B (03 cases): high columnar epithelium with cytoplasmic vacuoles. No necrotic areas. Pattern C (1 case): prominent lactiferous ductules with areas of necrosis and infarct. Pattern D (1 case): cytoplasmic vacuoles, and islands of ductal cells in a background of prominent foamy material. This internal nature of lesions on FNAC was not identifiable by clinical palpation alone. None of the lesions labelled as lactating adenomas on sonomammography showed any signs of malignancy on FNAC. Conclusions:FNAC is a useful method for confirming that a palpable breast lump in a lactating lady is lactating adenoma indeed. Four different patterns of microscopic appearances of lactational adenoma were noted in this study.

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