AIM: We aimed to compare the tru-cut biopsy and postoperative pathology results of breast lesions with suspicion of malignancy. Furthermore we aimed to determine the efficacy, specificity and sensitivity of the tru-cut biopsy. METHODOLOGY: 140 patients who were operated due to breast mass following tru-cut biopsy were retrospectively evalu- ated. Patients’ demographic characteristics, imaging findings, biopsy and histopathology results were compared. RESULTS: The mean age of 140 patients was 51.3 (Ranged: 17-83 ages). Malignancy was statistically more common in patients older than 45 years old. According to tru-cut biopsy results 103 (73.5%) lesions were malign, 32 (23%) benign, and 5 (3,5%) suspicious. Histopathological evaluation established 113 (% 80.7) malign and 27 (19,3%) benign lesions. Tru-cut biopsy had a sensitivity, specifity, positive predictive value, negative predictive value and diagnostic accuracy of 93.5%, 95.4%, 99%, 75% and 80%, respectively in this study. CONCLUSIONS: Our findings have confirmed that tru-cut biopsy is an accurate, reliable and as effective as open surgery for breast cancer diagnosis. The higher success rates may achieve by accordance of triple assessment which includes clin- ical, radiological and pathological evaluation with tru-cut biopsy.