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Introduction: Palpable breast swelling, whether benign or malignant, results from hormonal influences. Most cases are benign. Triple assessment—clinical, histological, and radiological—enables accurate detection and evaluation, guiding effective interventions. The research aimed to compare the patterns of breast swelling in premenopausal and postmenopausal women and identify the most common breast lumps in each group. Methods: One hundred female patients with palpable breast lumps were evenly divided into premenopausal (50 patients) and postmenopausal groups (50 patients). Each patient underwent clinical examination, fine-needle aspiration cytology (FNAC), and core needle biopsy if necessary. Ultrasonography (USG) of the breast was conducted for all patients, and mammograms were performed for selected cases. All postoperative specimens underwent histopathological examination. Results: Among the total 100 patients, 60 were diagnosed with benign breast disease, and 40 had malignant breast disease. In premenopausal women, 82% were diagnosed with benign disease, while in postmenopausal women, 38% had a benign diagnosis. Conversely, premenopausal women showed an 18% incidence of malignant breast disease, while postmenopausal women exhibited a 62% incidence. Among malignant breast diseases, 60% were invasive ductal carcinoma, 32.5% were invasive lobular carcinoma, 5% were invasive medullary carcinoma, and 2.5% were inflammatory carcinoma. Conclusion: The study finds a higher prevalence of malignant breast disease in postmenopausal women, while premenopausal women commonly experience benign breast disease, notably fibrocystic cystic disease. Premenopausal women exhibit a higher percentage of invasive lobular carcinoma than the general population, while postmenopausal women predominantly face invasive ductal carcinoma breast NST/NOS with increased invasive lobular carcinoma. [ABSTRACT FROM AUTHOR]