Primary tuberculosis of the breast is a rare clinical entity. We report a case of primary breast tuberculosis in a 58 year old lady presenting with palpable lump in the breast with axillary lymphadenopathy, masquerading as carcinoma of the breast. Clinical features are not specific and radiological imaging is of limited value. A cyto-histopathological study for identification of the acid-fast bacilli (AFB) is an important diagnostic tool. Clinical suspicion is important for early diagnosis and appropriate management. Anti-tubercular therapy is the mainstay in treatment and surgery is required only under certain circumstances.