The significance of primary tubercular mastitis is due to rare occurrence and often overlooked and misdiagnosed as pyogenic breast abscess or malignancy. Despite the high incidence of tuberculosis in India, reports of breast tuberculosis among the total number of mammary conditions varies between 0.64% and 3.59%. We report a case of a 35-year-old lady with breast lump of 3 months duration, which simulated malignancy on clinical examination but fine needle aspiration cytology revealed granulomatous mastitis secondary to tuberculosis. High level of suspicion and simple fine needle aspiration procedure with micro-biological tests will clinch the final diagnosis.