Radiological assessment and histopathological evaluation are among the critical tools for breast cancer diagnosis and staging. This study interrogates the concordance between computed tomography (CT) imaging and histopathological measurements for staging breast cancers. This prospective observational study, conducted at Jinnah Medical Postgraduate Center (JMPC), Karachi, Pakistan, enrolled female patients with a minimum age of 18 years, histologically proven breast carcinoma, no history of recent breast excision or post-neoadjuvant chemotherapy. Among the 293 patients enrolled, ethnicity of majority patients was Urdu Speaking (n = 144, 49.1%), followed by Sindhi (n = 10, 38.6%), Punjabi (n = 27, 9.2%), and Pathan (n = 08, 2.7%). Moreover, 295 (97.3%) patients were married, 176 (60.1%) were postmenopausal, 108 (36.9%) were of age 51-60 years, 281 (95.9%) were house-wives, and 275 (93.9%) patients presented with invasive ductal carcinoma (IDC) breast. The number of breast cancer patients presented with tumor size T1 and T2, as classified with CT and histopathology studies was (107 vs. 95) and (129 vs. 139), while the N0 and N1 nodal status was (207 vs. 118) and (86 vs. 122), respectively. The number of patients with TNM stage of 1A, 2A, 3A, 1B and 2B as evaluated with CT and histopathology was (70 vs. 33), (117 vs. 49), (0 vs. 40), (0 vs. 36) and (10 vs. 115) patients, respectively. These results indicate substantial discordances between CT imaging and histopathology in the assessment of tumor size, nodal status and TNM stage of breast cancer.