Background: Most palpable breast masses and lesions are benign; less than 30% of women with palpable masses have a diagnosis of cancer. Materials and Methods: The aim of this study was to describe the epidemiological and pathological characteristics of benign breast disease (BBD) and breast cancer (BC) among women who underwent a breast biopsy in the Department of Pathology,Hatyai Hospital, Songkhla, Thailand from January 2003 to December 2011. Results: Of the 2,532 biopsy reports of breast reviewed, there were 1,846 (72.9%) women with BBD and 686 (27.1%) women with BC. The most common form of breast disease diagnosed was fibroadenoma, followed by BC and fibrocystic change. BBD occurred in women under 40 years of age whereas BC occurred in women over 40 years of age (p < 0.001, OR = 8.629, 95%CI = 6.939 - 10.729). Fibroadenoma occurred in women less than 40 years of age while BC occurred in women over 40 years of age (p < 0.001, OR = 23.906, 95%CI = 18.359 - 31.129). Fibrocystic change occurred in patients less than 40 years of age while BC commonly occurred in patients 40 years of age and over (p < 0.001, OR = 3.865, 95%CI = 2.993 - 4.991). Conclusion: The overall incidence of BBD and BC has increased over the past nine years. It is important for pathologists and oncologists to recognise BBD especially fibroadenoma and fibrocystic change to assess a patient’s risk of developing BC and to establish the most appropriate treatment for each case. Moreover, continued vigilance, and mammographic screening should be established for early diagnosis of BC.