Evidence suggests that in experienced hands fine needle aspiration biopsy (FNAB) is highly safe and effective for the evaluation of patients who have palpable breast lesions. In most cases, FNAB leads to an appropriate clinical or surgical management. FNAB can also be effectively used in evaluation of cystic lesions under ultrasound guidance. Other nonpalpable lesions can benefit from image-directed core needle biopsy (CNB). Overall, cost should influence the decision to use FNAB or CNB. FNAB may be the only affordable procedure in developing countries. Breast cancer affects significant numbers of women worldwide. Attempts should be made to take all the measures necessary to consider optimal approaches to breast health care for everyone regardless of age, race, ethnicity, or social status.