Tubercular mastitis is a great masquerader and is an extremely rare entity as extra-pulmonary tuberculosis even in endemic countries like India and incidence accounts for 4% of breast lesions.
We report a case of primary TB of breast in a elderly female presenting as diffuse upper left breast lump with indurated and ulcerated overlying skin along with retraction of nipple. Clinically suspicion was of abscess and duct ectasia. Fine needle aspiration cytology (FNAC) of breast lump with touch imprint smears was done. FNAC showed epithelioid cell granulomas, Langhans type of giant cells with the presence of acid-fast bacilli on Ziehl Neelsen (ZN) stains.
FNAC diagnosis of tubercular mastitis is a useful tool for the proper management and treatment of patient thus avoiding unnecessary surgery.